Facility Evaluation Report

On May 6, 2025, at 10:30am, Licensing Program Analysts(LPAs) Noel Wolf Petersen and Michael Bilger arrived unannounced to conduct an annual visit of the facility. They were met by Kathleen Quiaot, and explained the purpose of the visit. This is an Adult Residential Facility with a census of 4 nonambulatory clients and 6 maximum.

The LPA’s inspected the physical plant, including but not limited to: resident bathrooms, resident bedrooms, hallways, evacuation routes, common areas such as the kitchen and recreation zone, and the facility exterior. The required furniture and furnishings were found to be present and in good repair. The facility is noted to be clean, with no obstructed or poorly lit traffic areas. Required posters are present: the ombudsman poster, the administrator certificate, federal workers rights and emergency evacuation route on the facility sketch. The fire extinguisher was last checked 7/22/24, the fire drills were logged to be conducted at least quarterly, resident water temperature was recorded at 105.1*F, between the required 105-120*f. air temperature was kept at 77*f. Sharps and toxics and medication are in locked storage away from residents in care, and the first aid kit was inspected and found to have all required items. 2 days of perishable and 7 days of nonperishable food was observed and inside its expiration window.

Client and staff files were reviewed and had the required documents. Five (5) staff files were reviewed, including the first aid certificate and the required fingerprinting. Four (4) client files were reviewed, including, IPP, admission agreement, medication and MAR were found to be in order, with up to date uses of the medication reflected in the available medication. liability coverage is up to date, expiring 9/23/25.

No citations were issued at this time, the report was read and given to the staff at the conclusion of the visit.