Facility Evaluation Report

Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a required annual inspection utilizing the inspection tool. LPA met with staff and explained the purpose of the visit. Assistant Administrator arrived at the facility shortly afterwards to assist with annual inspection.

There are five clients in care, facility is licensed for six ambulatory clients.

During today's inspection, LPA and Assistant Administrator conducted a tour of the interior of the facility. Areas toured included but not limited to: three shared client bedrooms, staff room, bathroom, medication room, laundry room, kitchen, garage and the common areas. LPA observed facility to have medications, toxins, and sharps to be locked and inaccessible to clients in care. LPA observed facility to have ample supply of perishable and nonperishable foods. LPA observed facility to be at a comfortable temperature of 72* degrees. LPA observed facility to be safe and sanitary, no immediate concerns observed.

File review was conducted for three client records and three staff records. LPA observed files to be complete and organized.

CARE tool was completed and found facility to be in compliance, no deficiencies cited.

Exit interview conducted and a copy of report was provided.