Facility Evaluation Report

On 07/17/23, Licensing Program Analyst (LPA) Michelle Echeverria arrived unannounced to conduct the required annual visit to the facility. LPA met with Administrator, Shawn Barracks, introduced self and stated the purpose of the visit. LPA was informed that there is currently 19 clients in the facility.

The facility has 14 client bedrooms, 8 bathrooms, 2 offices, kitchen, dining area, 4 activity rooms, medication room, laundry room, storage room, and fishing pond. LPA completed a walk through of the facility, review of records and medication audit.

Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature between 76-80 degrees fahrenheit in all rooms. LPA inspected the clients bedrooms; all rooms are equipped with required furniture such as: mattresses, night stands, chairs, storage space, and sufficient lighting. LPA inspected clients bathrooms; bathrooms were clean and appliances were functional. An adequate supply of linens and blankets stored in a cabinet inside the laundry room. Water temperature in kitchen faucet tested at 114.7 degrees fahrenheit. The facility is equipped with operational smoke detectors, carbon monoxide alarms, fire extinguisher, first aid kit, and emergency kits. Posters such as; the personal rights, disaster plan and CCL complaint poster were posted in a common area. Cleaning supplies, toxins, and sharps were left unlocked and accessible to clients. Deficiency issued. Medication was kept secured in cabinets inside the locked medication room made inaccessible to clients. There was a designated storage space for clients/staff files inside a filing cabinet in the office. The facility has a working telephone line.

Food Service : Non-perishable and perishable food supply is sufficient for number of clients in care. Dishes, cups, and utensils were stored properly.