Facility Evaluation Report

Licensing Program Analyst (LPA) Venus Mixson conducted an announced pre-licensing inspection. LPA met with Administrator Justina Thomas. Currently there are 0 residents in care. The application is for an Adult Residential Facility (ARF) with a capacity of 4 ambulatory residents.

A tour of the facility was conducted inside and out. The facility is a one story, four (4) bedroom, two (2) bathroom home with a living/ dining room, garage and kitchen. There are no pools, bodies of water, firearms or ammunition. LPA observed the bedrooms to be appropriately furnished with adequate lighting. Bathroom toilets, shower and tubs were having grab bars added at the time of the visit, and shall be completed before end of visit, but non-skid mats were in place. Hot water in the resident’s bathrooms were measured between 105- and 120-degrees F.

LPA observed food storage and preparation areas. Food preparation areas are clean and sanitary. Refrigerator and freezer are maintained at appropriate temperatures. The kitchen was observed to have dishes, silverware and pots and pans. All appliances are clean and operating properly.

There is a sufficient supply of linens, towels and personal hygiene items. The first aid kit was reviewed; all items are present. LPA observed a dining area where residents will have three meals served. Outdoor space is suitable for resident use and was observed to be fully fenced with an unlocked gate, and shaded area was being added on the day of the visit.

The fire extinguishers are completely charged.