Facility Evaluation Report

Licensing Program Analyst (LPA) Tricia Danielson conducted an announced visit to the facility for purpose of a Pre-Licensing evaluation. LPA met with Administrator Janice Jabonero. An initial application to operate an Adult Residential Facility (ARF) was received by the Central Applications Bureau (CAB) on 09/19/21 for a total capacity of four (4) ambulatory clients. Fire Clearance was granted for four (4) ambulatory clients on 10/07/21. LPA Danielson observed the following:

Facility was a one story house with four (4) client bedrooms, two (2) bathrooms, living room, family room, dining area and kitchen. There was an attached two 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 client bedroom will accommodate any ambulatory client. All client bedrooms were adequately furnished with bed, chair, closet, appropriate linens, adequate lighting, and an operable smoke alarm/carbon monoxide detector.

Both bathrooms have a working toilet, wash basin, and shower with an adequate supply of toilet paper, and soap. At 10:15 AM, LPA began testing water temperatures in client bathrooms. LPA verified water temperatures were measured at 110.6 and 109.4 degrees Fahrenheit.

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