Facility Evaluation Report

Licensing Program Analyst (LPA) Renee Campbell conducted an unannounced Annual 1-Year Required visit on this date. LPA met and toured with Administrator, Kathy Moore. The administrator currently holds a certificate (#6017494735) that expires on 07/25/2024. The facility’s fire clearance was approved for 07/01/2023.

LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 16 total bedrooms of which 16 bedrooms are occupied by the clients and 0 bedrooms are occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature for clients is maintained at 70-degree Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. Hot water temperature in the shared clients’ bathroom was measured at 118-degree Fahrenheit. All toilets, hand washing, and bathing are safe, sanitary and in operating condition. The supply of extra hygiene was available for clients. There is a minimum of 7-day nonperishables and 2-day perishables foods.

Smoke detectors are connected to the fire department. Fire extinguisher was last serviced on 02/08/2023. First aid kit was observed to be complete. Fire drill was last conducted on 03/25/23,

Staff records were reviewed, and all staff have criminal record clearance or a criminal record exemption and holds a current first aid certificate.

The following forms to be updated and submitted to CCL by : 04/28/2023

LIC 308 Designation of Administrative Responsibility

LIC 400 Affidavit Regarding Client/Resident Cash Resources

No deficiencies were cited during this inspection.

Exit interview conducted. Appeal Rights and a copy of this report provided.