Facility Evaluation Report

Licensing Program Analysts (LPAs) Abdoulaye Zerbo and Aziz Faizi conducted an unannounced one (1) year required visit. LPAs were granted entry by the Assistant Administrator Earlienne Rillo, who was informed of the purpose of visit. At the time of the visit there were no residents residing at the facility. The Assistant Administrator was observed to have obtained proper fingerprint clearance and was associated to the facility.

LPAs conducted a tour of the facility with Assistant Administrator Earlienne Rillo. The physical plant is a single-story structure that consist of 3 residents bedrooms, 2 staff bedrooms and 3 bathrooms, a laundry room, a living room, a dining area, a kitchen and attached garage. Water temperature was measured at 112-degree Fahrenheit meeting the requirements. Dishes and utensils were in sufficient supply and in good repair. Knives and other sharp objects are stored in a locked cabinet in the kitchen area . Disinfectant and other cleaning solutions were observed in a locked cabinet in the kitchen. According to Assistant Administrator, there are no firearms on the premises. Resident bedrooms had the required bedding, furniture, and lighting. Smoke and carbon monoxide detectors were observed to be operable.

The facility does not have any residents and staff, therefore, there were no staff/resident files for LPAs to review. During today's visit, LPAs did not observe any immediate violations or concerns.

An exit interview was conducted, and a copy of this report was reviewed and provided to Assistant Administrator Earlienne Rillo