Facility Evaluation Report

Licensing Program Analyst (LPA) Yolanda Delgado conducted an announced visit to the facility for purpose of a Pre-Licensing evaluation. At approximately 10:30 AM, LPA met with Licensee/Administrator Leena Dost. An initial application for Profit Corp to operate an Adult Residential Facility (ARF) was submitted to the Central Applications Bureau (CAB) on 11/15/2022 for a total capacity of four (4) ambulatory residents. Fire clearance was granted on 1/23/2023. Infection Control Plan on file. LPA Delgado observed the following:

Facility was a two-story house with three (3) resident bedrooms and two (2) resident bathrooms upstairs, living room, dining area, kitchen and office on the first floor. There was an attached two car garage in the front of the house and a one car garage attached on the side of the house.

Central heating and air conditioning system installed with a central panel located in the hallway on the second floor to control entire house.

Each resident bedroom #1, #2, #3 (shared) will accommodate any ambulatory resident, three (3) resident bedrooms were adequately furnished with bed, chair, closet, appropriate linens, adequate lighting, and an operable smoke alarm.

The two (2) resident bathrooms has a working toilet, wash basin, and shower with an adequate supply of paper towels, toilet paper, and soap, 1/2 bathroom on the first floor. At 11:00 AM, LPA tested the water temperatures in the resident bathrooms. LPA verified water temperature was measured at 106.3 degrees Fahrenheit.