Facility Evaluation Report

Licensing Program Analyst (LPA) Bianca Wolcott arrived announced to conduct an annual inspection. Upon arrival LPA was greeted by Jacqueline Bretz (Administrator) and Jennifer Getherall (Administration) and granted entry. LPA began inspection with introduction, visit purpose and provided the facility caregiver with LPA identification and business card. The facility has 4 client bedrooms, 2 bathrooms, kitchen, dining area, living room, laundry room, attached garage, and backyard. LPA completed a walk through of the facility and review of records.

Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. LPA observed the facility to be clean and in good repair. The home is maintained at a comfortable temperature for the residents. Lighting is sufficient for safety and comfort. Water temperature measured 103 within range. LPA observed a locked cabinet in office with locked sharps. LPA observed in garage a locked cabinet with cleaning supplies and chemicals.

Fire extinguishers are charged and mounted. All outdoor and indoor passageways are free of obstruction. Night lights and emergency lighting is present. There is a telephone working at this location. The LIC 610E, emergency disaster plan is maintained. The facility has a current written definitive plan of operation. The facility is maintained in conformity with the regulations adopted by the state fire marshal. Refrigerator is 37 degrees, and freezer is -0 degrees.

Personnel Records/Training/and Staffing-. LPA reviewed two (2) staff books for first aid certification, fingerprint clearance, personnel/job application, health screening and TB test results, criminal record statement, employee rights, training verification, and current administrator certification. LPA observed First Aid Book available at facility.