Facility Evaluation Report

Licensing Program Analyst (LPA) Jacqueline Shaw Ross arrived at the facility for the purpose of conducting a Annual visit. LPA Shaw Ross met with Kenyota Dokes, Regional Program Director and was informed of the purpose of today's visit. A tour of the facility was conducted inside and outside. The facility is approved for six (6) ambulatory residents. LPA Shaw Ross conducted staff and client interviews.

The facility is a three (3) bedroom, five (5) bathroom one story home. There are two (2) clients to each bedroom and each bedroom has a private bathroom. There is also a room for overnight staff, a staff bathroom, as well as a public bathroom.

In addition to three (3) bedrooms, the home also has a group room, nurses station, therapy room, family therapy room, kitchen, dining room, offices, backyard, laundry room, and recreation/art room.

LPA Shaw Ross observed the residents' bedroom to be clean and appropriately furnished. Common areas such as dining and living rooms were observed to be clean and in good condition. LPA tested Smoke detectors and carbon monoxide units and all were found to be operable. Outdoor and indoor passageways are free of obstruction at the time of this visit.

ADMINISTRATION/MEDICATION : LPA Shaw Ross observed a locked medication room with additionally locked cabinets where all medication is stored. Resident and staff records are electronic, and other physical records are locked and stored in staff office. LPA Shaw Ross observed monthly activity calendars. LPA Shaw Ross reviewed staff and resident files, and conducted three (3) staff interviews and three ( 3) resident interviews.