Facility Evaluation Report

Licensing Program Analyst (LPA) Renee Campbell arrived unannounced to conduct an annual

inspection. LPA Campbell met with Shannon Jackson, House Manager and explained the purpose of the visit.

The facility is a one story building with three bedrooms and two bathrooms and is licensed to serve 4 ambulatory residents, aged 18 to 59. Referrals are received from Valley Mountain Regional Center (VMRC).

As observed by LPA Campbell, there is only one client residing in the facility who was napping upon arrival. There are 6 staff working for the facility and during the visit, there were 3 staff present in the facility. Their client files indicate that the resident is able to ambulate without assistance. Of the 6 staff files, all were reviewed and found to be complete. All staff background checks were cleared.

LPA Campbell toured the facility and inspected common areas, the kitchen, bedrooms, bathrooms, and backyard areas to ensure there are no safety hazards for residents. Smoke and carbon monoxide alarms were tested anf found to be functioning.