Facility Evaluation Report

Licensing Program Analyst (LPA) Victoria Chitgian arrived to conduct an unannounced site visit to the facility for a required annual inspection. Facility is an Adult Residential Facility licensed for six (6) clients, four (4) of status non-ambulatory. Facility currently has a four (4) client census. LPA met with Licensee, Ahmed Qasim at the facility.

LPA conducted a walk-through the facility's interior and exterior. The facility has a charged fire extinguisher, operating fire alarm systems, and carbon monoxide detectors. Outdoor and indoor passageways were kept free of obstruction. LPA toured the kitchen. The facility had a two (2) day supply of perishable food items and seven (7) day supply of nonperishable food items. The facility menu was available for review and included nutritious options. LPA observed the inside of the refrigerators had leaked liquids. Licensee agreed to have staff clean the spilled liquids. Technical Assistance provided. LPA toured the client bedrooms. The client bedrooms had functional lighting and required furniture. The facility had a supply of additional linen and extra hygiene items for the clients. The facility had a complete first aid kit available. The facility has not documented their last emergency and disaster drill on record. Licensee agreed to begin documenting in a log. Technical Violation. Cleaning supplies were stored in the garage locked away. Centrally stored medications were kept in a safe and locked cabinet. Sharps were stored in a secured area. LPA toured the bathrooms and kitchen. Hot water temperature was measured in the bathrooms and was found above the required limits at 135 degrees Fahrenheit. The Licensee adjusted the water heater, but the temperature did not decrease. Technical Violation issued. Licensee agrees to post “Caution- Hot water” signs at all the faucets. The outside of the facility had a shaded area with seating for client comfort. The facility does not have bodies of water. LPA did observe numerous flies flying inside the facility. Technical violation issued.

LPA reviewed staff and client files. Staff files had the required documentation including a health screening report and first aid/CPR certification. Client files had the required documentation including an admission's agreement and appraisal/needs & services plans. LPA did not observe physician's reports(LIC 602) filed for four out of four(4/4) clients. Licensee was concerned of the missing LIC 602 in all client files. Licensee stated to immediately contact each of the client’s social workers to obtain copies of the LIC 602's.