Facility Evaluation Report

On May 6, 2025, at 10:30, Licensing Program Analysts(LPAs) Noel Wolf Petersen and Michael Bilger arrived unannounced to conduct an quarterly 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. Related inspection requirements to the annual are also present.

Client and staff files were reviewed and had the required documents. Further facility files were reviewed for documents related to the quarterly visits including but not limited to, a bag check log, a process for consent and refusal. No sharps or other easily weaponized objects were noted to be readily accessible to the residents without supervision. LIC 500 was reviewed to verifiy Administrator presence at least 40 hours per week. On 4-7-2025, Licensee participated in a technical support program (TSP) summary meeting which included general resources provided for aiding in compliance regarding care and supervision. Licensee has agreed to utilize provided resources including TSP powerpoint presentation on care and supervision, observation of the resident, and incident report writing.

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