Facility Evaluation Report

Licensing Program Analyst (LPA) Brian Balisi conducted a pre-licensing visit to the above noted facility. The LPA met with applicant Betsy Insular. The fire clearance was granted for four (4) non-ambulatory clients.

The facility is one story. At approx. 10:10am, a physical plant tour was conducted inside and out. The facility has four (4) private resident bedrooms. Resident room #3 have a direct exit to the outside. There are no fire sprinklers in the facility. Main hallway leading to resident bedrooms were observed to be equipped with fire door.

All resident rooms are set up with beds, nightstands, lamps, chests of drawers, chairs and closet space. The beds are furnished with comfortable mattress and clean linen; which includes, a mattress pad, top and bottom linens, pillowcases, blanket (if needed) and a bedspread. Lighting in the rooms appeared adequate. In addition, no bedroom was used as a passageway to another room, bath or toilet. There are two (2) staff rooms at the facility located to the right of the entry way. LPA observed rooms to be made inaccessible to residents in care. For NOC , there will be awake night staff only. All rooms were free of odors. All window screens were clean and maintained in good repair.

There are two (2) bathrooms total. The resident bathroom(s) have a shower with non-skid materials. The toilet and shower have grab bars. The hot water temperature was tested in the bathrooms and the kitchen and was found to be within the range of 105*F and 120*F.

Resident and staff records are to be stored inaccessible in a cabinet in the kitchen. Medications are to be centrally stored inaccessible in a locked cabinet in the kitchen.

The first aid supplies were complete , including a thermometer and a current version of a first aid manual. First aid was observed stored inaccessible in the locked cabinet as well.