Facility Evaluation Report

Licensing Program Analyst (LPA) Jacqueline Shaw Ross made an unannounced visit to the facility to complete the annual inspection. LPA arrived at the facility and was greeted by Administrator Maryrose Khan. LPA toured the inside and outside of the facility. The facility is approved to serve six (6) ambulatory developmental disabled adults, ages 18 through 59. At the time of the visit there three (3) clients present and one (1) staff present.

The facility is a eight (8) bedroom three (3) bathroom two story home. Two (2) bedrooms are shared, two clients to each room and two (2) bedrooms are single rooms for the clients. There are also four (4) bedrooms reserved for staff and administrator. During the inspection, LPA observed the facility to be clean and in good repair with no pathway obstruction. The clients bedrooms, bathrooms and the facility's kitchen, as well as the common areas were inspected and found to be in compliance. All required postings were posted throughout the facility. The facility does not have firearms and/or ammunition on the grounds. The facility is completing emergency drills regularly. The last drill was conducted on 6/14/23.

The facility is appropriately furnished. The water temperature was tested and measured at 105.4 degrees Fahrenheit. Indoor temperature measured at 73 degrees. The smoke alarms and carbon monoxide alarms were tested and found operable. LPA observed three fully charged fire extinguishers. The kitchen was observed to be fully stocked with a sufficient amount of food and supplies. Emergency food and water was stored in separate area in the garage. The knives were stored in a locked drawer in the kitchen. The medications are stored in a locked cabinet in the kitchen. P&I funds are kept in a locked room and are kept separate from facility funds. Chemicals and other hazardous items are kept in a locked cabinet in the garage. CONTINUE ON LIC809C