Facility Evaluation Report

Licensing Program Analysts (LPAs) Paola Guerrero and Ryan Gardner conducted an announced pre-licensing visit to facility. LPAs met with Administrator Gloria Thomas. The pending application is for licensee change for an Adult Residential Facility (ARF). There are currently three (3) clients in care. The Administrator accompanied LPAs on a tour of the inside and outside of the facility. The home is a four (4) bedroom, two (2) bathroom home with a living room, dining room, kitchen, attached garage, and game room. The physical plant, in general, was in good repair. The buildings and grounds are free from hazards. The indoor and outdoor passageways are free of obstruction. There are no pools, bodies of water, firearms, or ammunition. All bedrooms are furnished with a bed, nightstand, dresser, and chair. All bedrooms have adequate lighting for resident use. Bathroom's toilet, shower and tubs are in good repair and have non-skid mats. LPAs measured and observed the water temperatures in the bathrooms to be at 110.1 degrees F. LPAs observed food storage and preparation areas to be clean and sanitary. Refrigerator and freezer are maintained at appropriate temperatures. All appliances are clean and operating properly. Dishes, glasses, and utensils were in good condition. There is a sufficient supply of linens, towels, and personal hygiene items. The first aid kit was reviewed; all items are present. The backyard is completely enclosed with functioning gate to exit to front yard. The outdoor space is suitable for client use. LPAs observed fully charged fire extinguisher present in the facility. Smoke alarms and carbon monoxide are present and functional. Medications are stored and secured in a locked cabinet inside family room and inaccessible to clients. The facility had a designated are for staff and client records. Emergency disaster plans, personal rights, and complaint procedures were posted in a prominent area. There is adequate seating in the common areas. Facility had a supply of activities for the clients.

Pre-licensing inspection is complete, and no corrections are needed to be made. The Comp III presentation was completed during today's visit.

An exit interview was conducted, and a copy of this report was provided to the Administrator Gloria Thomas.