Facility Evaluation Report

Licensing Program Analyst (LPA) Jacqueline Shaw Ross and Licensing Program Manager (LPM) Tricia Danielson made an unannounced visit to conduct the required annual inspection. LPA was greeted at the door by Caregiver, Ludivina Frogoso and explained the purpose of the visit. Administrator, Emma Imson arrived shortly. LPA was informed the three (3) other clients reside at the home but were at day program. A tour of the facility was conducted inside and out. The facility is approved for four (4) Developmentally Disabled adults ages 18-59; all of whom must be ambulatory.

The facility is a one story 4 bedroom 2 bathroom home. There is also a bedroom designated for live-in staff. LPA and LPM observed clients bedroom furnishings to be in good repair with adequate lighting. Furniture throughout the house was observed to be in good condition. Clients have clean linen in good repair and sufficient hygiene products to meet their needs. All required postings are placed in a prominent area. Facility's Administrator certificate was noted to be active until 03/26/2025. Facility has multiple operating dual smoke alarms and carbon monoxide detector that meet statutory standards. Fire extinguishers were examined and determined to be in compliance. All inside and outside passageways are clear of obstructions. There are no pools or bodies of water observed. According to Administrator, no guns and/or ammunition are stored on the premises.

LPA observed the kitchen area to be clean and odor free with sufficient dishes and glassware. A two day supply of perishable, and a seven day supply of non-perishable, food items were observed. Hot water was measured at 116.0 degrees F. Temperature in the facility was 74 degrees. There is a locked storage area for medication. Chemicals and poisons are stored in a locked cabinet. (Continue on LIC809C)