Facility Evaluation Report

At approximately 9:00 AM, Licensing Program Analyst (LPA) Robert Frank arrived unannounced to conduct a Required 1 Year visit and was greeted by Caregiver (CG) Alice Gipson. LPA spoke on the telephone with Administrator Troy Skillman who was unavailable for today's inspection. Good Samaritan Care home, LLC is Licensed as an Adult Residential Facility. Facility is a single story ranch house. Facility has an approved fire clearance for six (6) ambulatory clients between the ages of eighteen (18) through fifty-nine (59). Upon arrival, LPA was informed that there were three (3) clients in care and two (2) staff members on-site. Two (2) of the clients were away at day programs during the inspection. At approximately 9:20 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 9:30 AM, LPA toured the facility with Caregiver Gipson. All exits were clear and unobstructed. The fire extinguisher was last serviced and tagged on 1/19/2025. Food supply was sufficient. The facility was sufficiently lighted. LPA inspected three (3) client bedrooms and found all to have sufficient lighting and furnishings as required per Title 22 Regulations. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for clients. Toxins were observed to be stored inaccessible to clients. The Facility does not have an internet access device. A Technical Violation is being issued for not having an internet access device. Facility has an infection control plan as required. The facility has a required emergency disaster plan. The facility is conducting fire and emergency drills quarterly. The last disaster drill was conducted on 1/11/2025. The facility does have emergency food and supplies to meet the "72-hour shelter in place" requirements. Hot water temperatures for all sinks in facility were found to be within Title 22 regulations of 105 to 120 degrees Fahrenheit. Facility smoke detectors and carbon monoxide detectors were tested and operational.