Facility Evaluation Report

Licensing Program Analysts (LPAs) Tricia Danielson and Chinwe Nwogene conducted an announced visit to the facility for purpose of a Pre-Licensing evaluation. LPAs met with Licensee Mona Ayad. An initial application to operate an Adult Residential Facility (ARF) was received by the Central Applications Bureau (CAB) on 12/9/21 for a total capacity of four (4) ambulatory clients. Fire Clearance was granted for four (4) ambulatory clients on 2/1/2022. LPAs observed the following:

Facility was a two story house with three (3) client bedrooms, two (2) bathrooms, 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 upstairs hallway to control entire house.

Each client bedroom will accommodate any ambulatory client. All client bedrooms were adequately furnished with bed, chair, closet, clothing storage, adequate lighting, and an operable smoke alarm/carbon monoxide detector.

Both bathrooms have a working toilet, wash basin, and shower. At 2:38 PM, LPAs began testing water temperatures in client bathrooms. LPAs verified water temperatures were measured at 117 and 118 degrees Fahrenheit.

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