Facility Evaluation Report

Licensing Program Analyst (LPA) Zabel Chochian conducted an annual required visit today. LPA met with facility staff and explained the reason for this visit. Administrator was contacted and arrived shortly after.

Upon entry a physical plant tour was conducted with staff at approximately 11am. Bedrooms: There are four (4) private bedrooms and two restrooms designated for residents' use. Strong urine odor was coming from client #3's room. All other bedrooms observed clean; all four (4) bedrooms were properly furnished and had sufficient lighting. Bathrooms: There are two (2) bathrooms designated for clients' use. Both bathrooms observed clean and properly supplied. Hot water temperature was 113 degrees Fahrenheit. Cleaning supplies observed locked in the cabinets in the garage. Common Areas : These included the living room and dining area. The common areas appeared clean and were properly furnished. Surrounding Grounds : Entry/exits were free of obstruction. The outdoor area was clean and free of hazards. Facility does not have a pool or any similar bodies of water at the property. All smoke/carbon monoxide detectors were tested and function properly. The fire extinguisher was located in the kitchen area and appeared functional with record of service date 03/15/2024. Kitchen: The kitchen appeared clean and the appliances and fixtures functional; observed at leasts two (2) day supply of perishable and seven (7) non-perishable food at the facility; properly stored. Knives and cleaning supplies are stored in locked cabinet under the sink. LPA observed sufficient cleaning/disinfecting supplies stored in locked cabinet in the garage.

LPA reviewed client and staff files between 11:30am-1pm. Client files reviewed included an admission agreement, quarterly updates, medical assessments, physician orders for medications and centrally stored medication logs. Client files did not include an updated individual program plan and behavior plan. Administrator stated that he recently followed up with the clients' Service Coordinator and is waiting for the updated IPPs'. Client files did include the Quarterly meeting updates.

Staff files reviewed for regularly scheduled staff at the facility. (Continue to LIC 809C)