Facility Evaluation Report

Licensing Program Analyst (LPA) Javina George conducted an unannounced annual/1 year required visit on the date and time noted above. LPA was granted entry by Caregiver Machona Merete, who was informed of the purpose of the visit. The Administrator Leena Dost arrived shortly after.

The facility is a two story home with (4) bedrooms and (3) bathrooms designated for the clients to use. LPA conducted a tour of the interior and exterior of the facility and observed the following:

Infection Control: The LPA observed the hand washing stations in the bathrooms. LPA also observed for the facility to have an adequate amount of Personal Protective Equipment (PPE) supplies. The facility has not submitted their Mitigation plan (LIC 808) that was to be submitted in January of 2021. deficiency will be cited.

Physical Plant: LPA observed the clients bedrooms which contained the required furniture. In the master bedroom LPA observed for their to be a chandelier light fixture with 5 light bulbs and 2 lamps that did not illuminate any light. The bulbs in the chandelier were not functioning and there were not any light bulbs in the other two lamps. Further observations made is the bathroom in the master bedroom has a broken handle on the sink closest to the shower. Deficiency will be cited. The interior and the exterior were observed to be clean, odor and clutter free. Other fixtures and furniture were observed to be in good repair. The facility does not have a pool or any other bodies of water on the premises. The water temperature was unable to be tested, as the hot water was shut off. Per the Administrator Ms. Dost, the facility was recently tented due to termites, for three days (4/22-4/24), and that the water company was coming by 4pm today (4/26) to turn the hot water back on. This information was confirmed by contacting the gas company. LPA inquired if the clients were not taking showers. Per Ms. Dost the clients were transported to the sister facility to take their showers. This information was also confirmed. LPA inquired as to the reason for bringing the client's back without the hot water and per Ms. Dost it was due to school and day programs and transportation not being able to make the extra three mile trip.