Facility Evaluation Report

Licensing Program Analyst (LPA) Dawn Segura conducted an unannounced required annual inspection. LPA identified herself, was granted entry into the facility, and met with Ed Parafina, Staff, to whom LPA disclosed the purpose of the visit.

According to the facility’s license, the facility is licensed for six (6) clients, two of whom may be non-ambulatory. During today’s inspection, there were six (6) clients residing in the home.

LPA, accompanied by staff, toured the facility. Pathways were free of obstruction and slip hazards. Doors, sinks, and toilet were in working order. The facility had sufficient indoor and outdoor space to facilitate visitation. Hot water temperature in bathroom sink in bathroom used by clients measured at 105 degrees F. A 7 day supply of food items was present in the home; however, there was no milk or eggs present at the time of the visit.

No open-faced heater or fireplace was present in the facility. No pools or bodies of water were observed on the premises. Per the staff, no firearms or ammunition are kept at the facility. LPA observed new smoke and carbon monoxide detectors present in the facility; however, they were still packaged and not installed. Facility telephone was in working order. Fire extinguisher was serviced within the last 12 months. Medications were labeled, as required, and stored in an area of the home that is inaccessible to clients. LPA conducted interviews and reviewed client records, none of which raised concerns.

Deficiencies are being cited and a technical advisory is being issued today. Civil penalty is being assessed due to the lack of installed smoke detectors.

Plans of correction were jointly developed with the facility staff. An exit interview was conducted with Ed Parafina, to whom a copy of this report, the LIC 809-Ds, the LIC421, LIC 9102TA, and the Licensee/Appeal Rights (LIC9058 03/22) were provided at the end of the visit.