Facility Evaluation Report

On 5/29/2025, Licensing Program Analyst (LPA) Janette Romero made an unannounced visit to the facility to conduct a required annual inspection. LPA was greeted and granted entry by Licensee, Rosie Mousser who was informed of the purpose of the visit. T he facility has a fire clearance to serve one (1) non-ambulatory and five (5) ambulatory clients. During the visit, LPA observed one (1) staff present and was informed all five (5) clients were attending day program.

LPA toured the facility with licensee and observed the facility is made up of a one-story home with three (3) client bedrooms, two (2) bathrooms, a kitchen, dining area, living room and laundry room. Client bedrooms had the required bedding, furniture, and lighting. Bathrooms had grab bars and non-skid mats in the showers. No bodies of water were observed on the premises. Indoor and outdoor pathways were free of obstruction. The facility has a two-day supply of perishable foods and seven-day supply of non-perishable foods. Medications and client files are secured in a locked kitchen cabinet. Licensee tested one (1) of the smoke alarms/carbon monoxide detectors and LPA observed it to be operational. LPA also observed a charged fire extinguisher mounted near the kitchen last serviced on 2/1/2025. Staff present has a criminal record clearance and is associated with the facility. Client files reviewed had updated physician's reports and signed admission agreements. LPA reviewed the facility's Fire Drill Log Notes documenting the facility's last fire drill was conducted on 4/21/2025. Clients' personal rights, complaint procedures, and house rules are visibly posted in the dining room. LPA reviewed the Record of Client's/Resident's Safeguarded Cash Resources (LIC 405) for all five (5) clients while licensee counted their physical monies. Licensee reported the LIC 405s were last updated on 5/26/2025 where licensee supervised staff count the clients' physical monies and no discrepancies were discovered. During today's review, LPA and licensee discovered Client 1 (C1) was missing $20 from their monies listed as the total balance. During the visit, licensee reported they contacted staff who was unable to explain the discrepancy.