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 Tanneh Koayen, Facility Manager. As an administrator she currently holds a certificate (#6030594735) that expires on 07/09/2023.

LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 5 total bedrooms of which 4 bedrooms are occupied by the clients and 1 bedroom is 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 71 degrees 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 107-degrees 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 and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 04/25/2023. First aid kit was observed to be complete. Fire drill was last conducted on 04/11/2023.

LPA reviewed 2 of 6 staff records and 2 of 6 client record. All staff files reviewed had current CPR training.

The following forms to be updated and submitted to CCL by 05/04/2023 .

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.