Facility Evaluation Report

Licensing Program Analyst (LPA) Iby Strong conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Administrator Tatiana Kurkies. According to the facility’s license, the facility has a maximum capacity of four (4) clients, of whom must be ambulatory. There are no clients present as facility is not yet vendorized by regional center.

The facility has two properties on cite, the back property has a different address assigned therefore, Department does not have jurisdiction over back home. LPA Strong, 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, toilets, and showers were in working order. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities.

Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to clients. Medications locker was viewed for future storage of medication. Hot water was measured at 118 degrees F.

There is an empty pond on cite with an appropriate locked fence. Per Administrator, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher was present. First aid kit was readily accessible. Required licensing postings were observed in visible areas of the facility.

No deficiencies were observed or cited during today's annual inspection.

An exit interview was conducted with Administrator Tatiana Kurkies, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.