Facility Evaluation Report

Licensing Program Analysts (LPA) Iby Strong and Hannah Rodgers conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPAs arrived at the facility but no one was present. Later, LPA's observed staff arrive and were welcomed by, identified themselves to, and discussed the purpose of the visit with Caregiver Sarah Alban. According to the facility’s license, the facility has a maximum capacity of six clients, of whom 2 may be non-ambulatory.

LPAs toured the interior and exterior of the facility, and inspected each room. The facility was clean and sanitary. Two doors leading to the outdoors were observed without top door knob, leaving rooms subject to outdoor elements. Floor tile and walls in room 3 were observed to be incomplete. Pathway outdoors was observed to be obstructed with construction rock debris. One out of four client bedrooms did not contain a night stand, two of four client rooms were observed not to have chairs. Windows, 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.

Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to clients. Two days of perishable food and seven days of non-perishable food was present. Some medications were observed to be locked though, during physical inspection LPAs observed a brown paper bag with numerous unstored medications next to dinning room

No pools or bodies of water on the premises. Per Sarah no firearms or ammunition are kept at the facility. Carbon monoxide detectors, and facility telephone were all working. There was no emergency lighting present. Fire extinguisher was present. First aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility. Fireplace was observed uncovered. Confidential records were stored in locked areas. Client record reviewed contained required documents. Staff records reviewed contained required documents.

Multiple deficiencies and one technical violation were issued on today's date. An exit interview was conducted with Sarah Alban with Administrator Juna Barlis present via telephone, to whom a copy of this report, LIC809 Dx3, LIC9102 and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit