Facility Evaluation Report

Licensing Program Analyst (LPA) Jose De La Cruz made an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit with S1, and Licensee Jeff Jackson. The facility's license shows a maximum capacity of 4 ambulatory residents, ages 18-59. During today’s inspection there were 3 residents in care.

LPA arrived at 2:30 pm, facility looks clean and in good repair and decorated for the Holidays. At 3:00 pm LPA reviewed requested clients’ files and at 3:45 pm, LPA reviewed the staff files. LPA and Licensee started the facility tour around 4:35 pm.

LPA and Licensee toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities.

The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to clients. Around 5:10 pm, LPA and licensee checked the medications storage. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises.