Facility Evaluation Report

Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced required 1-year visit to the facility. LPA met with Facility Representative Ronald Albert and discussed the purpose of the visit.

The facility is an Adult Residential Facility (ARF) with license capacity of (4) and a current census of (0). The facility currently has no care staff and no clients in care.

LPA conducted an overall inspection of the facility, which included, but was not limited to, the following:

LPA observed indoor and outdoor passageways are kept free of obstruction. Outdoor activity space is shaded and enclosed by a self-latching gate. No bodies of water were observed. The facility has sufficient lighting. Sharps, disinfectants, cleaning supplies are kept locked. Facility has smoke/carbon monoxide alarms, two (2) fire extinguishers, laundry equipment, towels, bed linen, personal hygiene products, first aid kits, and emergency supplies. The facility has posted, facility license, emergency disaster plan, and evacuation sketch. Client bedrooms are equipped with clean mattresses, bed linen, nightstands, chairs, and lamps. Client bathroom equipment is operating in a safe and sanitary condition. The hot water temperature tested at 119 degrees F. LPA observed a locked cabinet where medications and client files will be stored. Kitchen and dining areas were maintained clean. The facility has a sufficient supply of nonperishable and perishable food. The facility has sufficient food storage areas and clean utensils, cups and plates.

No deficiencies were cited during today's visit. An exit interview was conducted where this report was discussed, and a copy of this report was provided to the facility representative at the conclusion of the visit.