Facility Evaluation Report

On 06/24/2023, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required Inspection. LPA Medina allowed entrance by House Manager. Tiffany Johnson, Administrator was present during facility inspection.

Currently, 4 residents are in placement. All residents were present during today's inspection.

Facility tour conducted with Administrator and House Manager. Facility observed to be well lit, clean and odor free. All common areas have adequate seating available. Resident bedrooms toured, all bedrooms observed to have required furnishings. Bathrooms toured, showers observed to have non-slid mats and grab bars. Water temperature during facility inspection measured at 114 degrees F. Kitchen toured, all sharps observed to be locked and secured in lock box. Facility observed to have a 2-day supply of perishable and 7-day of non-perishable available. Medication observed to be locked and secured in medication cabinet. Medication observed to be administered as ordered. Smoke detectors and carbon monoxide detector observed operational during inspection. Fire extinguisher present with a purchase date of 2/16/23. Chemicals are locked and secured in laundry room

Outside of facility toured. All exits open free of obstruction. Perimeter of back yard is secured with a fence and free of obstruction.

LPA received updated copies of Administrator Certificate, LIC 500, LIC 610, LIC 9020, and surety bond during inspection.

Exit interview conducted. No deficiencies cited. A copy of this report provided for facility records