Facility Evaluation Report

Licensing Program Analyst, LPA, Noel Wolf Petersen arrived unannounced at 1:00pm on 9/30/25 and met with imani warren and christorpher walters to explain the purpose of the visit: to conduct the post licensing inspection. Integrating home care is a facility for 4 adults aged 18-59, the facillity is seeking an exception for a g-tube for an incoming resident. and has a current census of 1.

Physical plant inspection was conducted, including bedrooms, bathrooms, common areas, exteriors, evacuation routes, and storage areas. The facility is clean, traffic areas are well lit and unobstructed. The kitchen has adequate lockable space for toxics, sharps, and medications. The common areas and exteriors have adequate space and are absent of tripping hazzards. The bedrooms have required furniture and furnishings, bathrooms have functional hardware and water being delivered between 105-120*F. The evacuation route is functional. Posters and postings are of the correct dimension and kind, the fire extinguisher is dated 1/13/25. Smoke/CO alarm is functional. evacuation gate could use some wd40. The upstairs master bedroom needs its shower to be functional, bathtub is functional and the room is unused.

3 of 3 Staff files contained up to date records for the following documents: Cpr/firstaid, Criminal Backround checks, gaurdian clearance. 1 of 1 resident files contained up to date records for the following documents: Signed admission agreement, house rules, up to date IPPs, recent medical assessement, preappriasals, Safeguarded cash and property, TB assessment, and medication and MARS in agreement. 1 client interviewed, 1 staff interviewed.

Administrator files contained up to date records for the following documents: house rules, LIC 500, LIC 9020, BloodBorne pathogen training(HIV), Facility sketch, sample admission agreement.

No citations at this time, a copy of the report was read and given to the administrator.