Facility Evaluation Report

On 09/03/2025 at approximately 09:05AM Licensing Program Analyst (LPA) Deniz arrived unannounced to conduct a Required 1 Year visit and met with Staff Member, Gilbert Mishiame. Administrator, Deborah Johnson-White, arrived at approximately 10:15AM. Facility is an Adult Residential Home that provides care and assistance for Adults with Disabilities. Facility has an approved fire clearance and capacity for 4 Ambulatory Clients. Upon arrival, LPA was informed that there were 1 client in care. LPA was also observed that there was one staff member on-site. Facility is a 2 story building with 4 Resident bedrooms, 2 bathrooms, and common spaces.

At approximately 10:45 AM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation.

At approximately 10:55AM, LPA toured the building and grounds which was found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed. All notices that are required to be posted have been posted. LPA observed activity supplies for resident use. The amount of fresh and nonperishable foods is within regulation. Facility kitchen, refrigerators and freezers were clean, and food was stored properly. Toxins are stored in a locked in the garage cabinet and kitchen cabinet under the sink. Water temperature measured 116.6 degrees F and 107.4 which is within regulation between 105- and 120-degrees F at faucets accessible to residents. Fire extinguishers were bought new on 10/29/2024. Carbon Monoxide detectors were present and in order. There was enough lighting in all common areas, resident rooms, and hallways. Medication is centrally stored and secure.