Facility Evaluation Report

Licensing Program Analyst (LPA), David Roman conducted a Pre-Licensing inspection. An initial application to operate an Adult Residential Care Facility was completed on 11/30/24. The facility was approved to care for six (6) Ambulatory Residents. LPA was greeted and allowed entry into the facility by Operations Manager, Jennie Alshouse. LPA met with Jennie Alshouse, Cameron McCabe, and Robert Satterfield.

The facility is a single story structure with 4 bedrooms and 2 bathrooms. There is an outdoor covered area for resident use. Outdoor hot tub identified in facility sketch as a body of water (covered and locked) were observed. Rooms #1-#4 may be used for ambulatory residents. No bedroom for staff. All bathrooms have a functioning toilet, sink, grab bars and tub/shower with non-skid mats. The house has adequate supply of linens, towels, hygienic products, food, and cleaning products. Fire clearance was approved on 12/02/24.

Emergency exit facility sketch plan and required postings present (missing menus). Smoke detectors and carbon monoxide detectors- interconnected and hardwired. Home appliances, stove burners, oven, microwave, washer, and dryer working. Cleaning chemicals are stored in a locked cabinet. Water temperature measured at 120 degrees F. Medications are to be centrally stored and locked in a closet. First-Aid Kit accessible in the kitchen area. Resident files will be located in front locked closet. Staff files maintained centrally stored at corporate office and made readily available upon request. Resident activities consist of adequate supplies to include books, exercising, painting, and puzzles for resident's use.

LPA D. Roman completed the Pre-Licensing inspection visit. Information provided about how to operate the facility within substantial compliance. All items reviewed during the visit are in compliance. Pre-licensing is complete and this facility has no deficiencies. Facility appears to be ready for licensor pending final review.

An exit interview was conducted and a copy of this report was provided to Operations Manager, Jennie Alshouse signature below confirms receipt of this report and rights.