Facility Evaluation Report

Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by and discussed the purpose of the visit to House Manager Pat Ruis. According to the facility’s license, the facility has a maximum capacity of thirteen (13), all of whom must be ambulatory.

LPA and House Manager 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. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. Facility contained 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. No toxic chemicals/poisons were accessible to clients. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per House Manager, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and clients and reviewed records/files. The files reviewed contained required documents and confidential records were stored in locked areas.

No deficiencies were observed or cited during the inspection. An exit interview was conducted with House Manager Pat Ruis to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.