Facility Evaluation Report

Licensing Program Analyst (LPA) Martha Arroyo conducted a pre-licensing visit to the above noted facility. The LPA met with applicant, Fatuma Nassanga. This will be a new facility . The facility will be a Regional Center vendorized home dedicated for intellectual disability clients.

The facility is a one story home. At 2:00 p.m., a physical plant tour was conducted inside and out. An approved fire clearance was received, clearing them for two (2) non-ambulatory clients and two (2) ambulatory clients. The facility has four (4) private client bedrooms, Rooms #1, #2, #3, and #5. Two (2) client rooms have direct exits to the outside. All client rooms are set up with beds, night stands, lamps, chests of drawers, chairs, and closet space. The beds are furnished with box springs, comfortable mattress, and clean linen. Lighting in the rooms appeared adequate. The bedrooms were large enough to allow for easy passage between the beds and furniture with a wheelchair if needed. In addition, no bedroom was used as a passageway to another room, bath, or toilet. Room #4 and #6 are designated staff rooms. All rooms were free of odors. All window screens were clean and maintained in good repair.

There are two (2) bathrooms in the hallway designated for both client and staff use. And Client room #3 has a private bathroom. The client bathroom(s) has 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 degrees Fahrenheit and 120 degrees Fahrenheit. Client and staff records are stored in a locked cabinet which is currently located adjacent to the living room. Medications are centrally stored in a locked cabinet adjacent to the kitchen. The first aid supplies were complete, including a thermometer and a current version of a first aid manual. They were stored in a cabinet adjacent to the living room. Kitchen knives are stored in a locked cabinet adjacent to the living room. There are no pesticides or toxins stored in any food storage area or preparation area with utensils. Appliances in the kitchen were clean and all appeared functional. Trash cans had tight fitting lids. ...Report Continued on LIC 809C...