Facility Evaluation Report

Licensing Program Analysts (LPAs) Yolanda Delgado and Kathleen Banrasavong conducted an announced visit to the facility for purpose of a Pre-Licensing evaluation. At approximately 9:15 AM, LPA met with Licensee Oluchi Iwuoha. An initial application for Change within Corporation to operate an Adult Residential Facility (ARF) was submitted to the Central Applications Bureau (CAB) on 12/2/2022 for a total capacity of four (4) ambulatory residents. Fire clearance was granted on 1/4/2023. Infection Control Plan on file. LPA Delgado observed the following:

Facility was a one-story house with four (4) resident bedrooms, two (2) resident bathrooms, living room, dining area and kitchen. There was an attached two (2) car garage in the front of the house.

Central heating and air conditioning system installed with a central panel located in the hallway to control entire house.

Each resident bedroom #1, #2, #3 and #4 will accommodate any ambulatory resident, bedroom #5 is the office and bathroom #3 is designated for staff. Four (4) resident bedrooms were adequately furnished with bed, chair, closet, appropriate linens, adequate lighting, and an operable smoke alarm.

The two (2) resident bathrooms has a working toilet, wash basin, and shower with an adequate supply of paper towels, toilet paper, and soap. At 10:15 AM, LPA tested the water temperatures in the resident bathrooms. LPA verified water temperature was measured at 105. degrees Fahrenheit.

An adequate supply of dishes, glasses, utensils, pots and pans were observed. Knives/sharp instruments were secured in a locked drawer located in the kitchen. There was adequate room for food storage. LPA observed the stove to be operational. Refrigerator/freezer were in working condition.