Facility Evaluation Report

Licensing Program Analyst (LPA) Bernadette Allen conducted an announced visit to the facility for purpose of a Pre-Licensing evaluation. An initial application to operate an Adult Residential Facility was submitted to the Central Applications Unit (CAU) on 6/12/2022 for a total capacity of 4 ambulatory residents. Fire Clearance was granted 06/29/2022 LPA, Allen observed the following:

Structure: Facility was a two story house with a total of five(5) bedrooms and 3.5 bathrooms. There are three (3) resident bedrooms and one (1) staff bedroom, office area, and loft upstairs. There is one (1) bedroom downstairs, a living room, dining, and kitchen area. The home has central heating and air conditioning systems.

Bedrooms : Each resident bedroom will accommodate ambulatory clients only. All bedrooms were adequately furnished with bed, chair, closets, appropriate linens, and adequate lighting.

Bathrooms: Bathrooms have a working toilet, wash basin, and shower with an adequate supply of towels, toilet paper, and toiletries. Water temperature measured at 105.6 F in the main bathroom downstairs in the common area.

Kitchen: An adequate supply of dishes, glasses, utensils, pots, and pans were observed. The knives/sharp instruments were secured in a locked cabinet by the refrigerator. There was adequate room for food storage. The refrigerator/freezer were in working condition . There was a 7-day supply of nonperishable food and 5-day supply of perishable food. There was adequate seating for meals.

Living/Family room: Furnished with safe and adequate seating and furnishings. All items appear to be in good repair.

Linens and Hygiene Supplies: An adequate supply of linens are available.

Yards/Outside: There is a covered patio area for staff and client use. There were no bodies of water observed anywhere on the property.