Facility Evaluation Report

Licensing Program Analysts (LPA) Liliana Silveira conducted an unannounced 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 Licensee Cheryl Baum and House Manager Carrie Baum.

According to the facility’s license, the facility serves six (6) developmentally disabled adults, ages 18-59, all of whom must be ambulatory. There are currently 6 clients in care and per medical records, the clients are ambulatory. During today’s inspection, all clients were not present in the home. This facility does not feature a secured perimeter or delayed egress doors.

LPA, accompanied by Cheryl and Carrie, 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 and 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’s ambient internal temperature was 72 F. Hot water temperature at taps accessible to clients were all compliant.

There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to clients. Medications were labeled, as required, and stored in locked areas. (continued on next page, LIC 809-C).