Facility Evaluation Report

At approximately 11:55 AM Licensing Program Analyst (LPA) Stevenson arrived unannounced to conduct a required - 1 Year Inspection, and was met by caregiver J.M. who called Licensee/Administrator Debbie Miller who arrived at 12:45 PM to assist with today's inspection. Facility currently cares for four clients, all of which were away at day programming or in the community during this inspection. Licensee is working with the Central Application Bureau to effect a change of location to a nearby home owned by licensee (copy of deed obtained) The move has a target date of February 13th, 2026 (lease on current property ends February, 28th 2026)

Fire clearance approval is for four (4) ambulatory clients. Facility has an infection control plan as required. Facility has an emergency disaster plan as required. Fire extinguishers one (1), were serviced and tagged as required, dated 12/10/2025. All exits were cleared and free of obstruction.

Last emergency disaster drill was conducted on 09/24/2025. Administrator understands that the drills are held quarterly, ensuring one is an evacuation drill.

LPAsreviewed four (4) resident files. P&I monies were intact and records were maintained as required.

Medicines were found to be centrally stored and secure and a spot check of medicines shows them to have been administered correctly, however the documentation of administration was missing in two (2) of five (5) spot checks of documentation and licensee is reminded to insure continuous accurate documentation of medicine administration and a technical violation of (80075(b)(5)(C) was issued.

LPA reviewed four (4) staff files. All staff had training, including first aid. All staff had criminal record clearance as required.