Facility Evaluation Report

Licensing Program Analyst, LPA, Noel Wolf Petersen, arrived unannounced at 1:45pm on 10/29/25 to conduct an annual inspection. LPA met with Vita Gumagay to explain the purpose of the visit, GM arf, llc is a 5 capacity adult residential facility for M/f 18-59. no current waiver and exceptions for clients in care. there are 4 ambulatory, 1 nonambulatory, 0 bedridden.

Physical Plant was inspected including the kitchen, common areas, bathrooms, bedrooms, exteriors, evacuation route. The facility is clean, the traffic areas are unobstructed and well lit. The kitchen has adquate storage for sharps, medication and toxics. common areas and exteriors are free of trip hazards and have adquate space for activites. bathrooms have hardware in good repair, water is delivered between 105-120. The bedrooms have required furniture and furnishings. evacuation routes are in good repair.

2 clients mars were checked for agreement with the availible medications. They were in agreement. 2 clients PI were checked for agreement with availible monies. they were in agreement

The fire extinguisher is dated mar 2025., the smoke/co alarm is functional. first aid kit has necessary items

5 of 5 client files were reviewed, including but not limited to ipps, signed admission agreements, valubles, predadmission appraisal, and 602's. files present and up to date. administrator files were reviewed, including but not limited to facility license, administrator certificate, fire clearance, gaurdian clearance, infection control plan, and evacuation control plan. files are present and up to date. 5 of 9 staff files were reviewed, including but not limited to fingerprint/backround clearance, first aid/cpr, and ongoing training. files are present and up to date. 4 clients interviewed. 1 staff interviewed.

A copy of the report was read and given to the administrator, no citations issued at this time. an exit interview was conducted.