Facility Evaluation Report

Licensing Program Analyst (LPA) Renita Hall conducted a Case Management visit regarding an increase in capacity application. LPA identified herself and discussed the purpose of the visit with the caregiver. The licensee was available via phone.

The licensee applied for an increase in capacity from a total of six (6) clients to a total of seven (7) clients, of whom seven (7) may be non-ambulatory with seven (7) hospice waivers. There is an approved Fire Clearance for the increase in capacity and non-ambulatory status. As of today, there are clients in care. LPA toured the facility and discussed with the licensee regarding operation.

LPA toured the physical plant. Client bathrooms are equipped with cleaning products and paper towels; toxic substances are stored in a locked cabinet. Medication storage and administration logs are located locked box in the Kitchen. Sufficient space to conduct activities was present; facility posting requirements were present in a common area; per the Licensee there are no guns, weapons, or ammunition located on the property. No deficiencies were issued during this visit.

An exit interview was conducted with Stephen Diaz, caregiver to whom a copy of this report, along with Licensee/Appeal Rights (LIC 9058 03/22), were provided after the visit.