Facility Evaluation Report

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Supervisor Pia Abille.

According to the facility’s license, the facility has a maximum capacity for six (6) clients, of whom all must be ambulatory. Per LPA observation, LIC602 Physician’s Reports, and staff interview: During today’s inspection, there were a total of three (3) clients in care, and all were ambulatory. LPA interviewed multiple staff and multiple clients who were present. LPA also reviewed the care records for all clients, and the personnel files for all active staff. LPA, accompanied by Licensee’s staff, toured the interior and exterior of the facility, inspecting all common areas and client bedrooms.

In the facility’s front yard, LPA observed two (2) old mattresses leaning against the shaded gazebo used by the clients. In the facility’s back yard, LPA observed assorted refuse, which staff confirmed was junk meant to be discarded (i.e. there was a metal bedframe leaning against the wall and sitting directly atop the facility’s gas main; there was a broken wooden dolly and other wood debris; there was a broken shopping cart).