Facility Evaluation Report

Licensing Program Analyst (LPA) Amy Goldenberg conducted an announced visit to the facility for purpose of a Pre-Licensing evaluation. An initial application to operate a Residential Care Facility for the elderly was submitted to the Central Applications Unit (CAU) on 01/06/22 for a total capacity of 6 non-ambulatory residents. Fire Clearance was granted 02/03/2022. LPA Goldenberg observed the following:

Structure: Facility was a single story house with four (4) resident bedrooms, two bathrooms, living room areas, dining area, and kitchen area.

Heating/Cooling System: Central heating and air conditioning systems.

Bedrooms: All bedrooms were adequately furnished with bed, chair, large closets, appropriate linens, adequate lighting, and an operational smoke alarm.

Bathrooms: Bathrooms have a working toilet, wash basin, and shower with an adequate supply of towels, toilet paper, and toiletries. Water temperature measured by LPA at 108.3 degrees F.

Kitchen: An adequate supply of dishes, glasses, utensils, pots and pans were observed. Cleaning supplies and knives/sharp instruments were secured in a locked cabinet and drawer. There was adequate room for food storage. Refrigerator/freezer were in working condition and had sufficient storage for perishable food. There was adequate seating for meals.