Facility Evaluation Report

Licensing Program Analyst (LPA) Zabel Chochian conducted a Pre-Licensing Inspection with Applicant Representatives Shannon Dobbs and Nicole Alex. An Application to operate a Social Rehabilitation Facility (SRF) was received by Community Care Licensing (CCL) on 03/09/2024. A Fire Clearance was approved for a maximum capacity of six (6) ambulatory residents on 03/24/2024.

A tour of the physical plant was conducted beginning at 3:45PM and the following observed:

The property is a single family dwelling home; four (4) bedrooms and four (4) bathrooms. The physical plant consist of an open floor plan concept with kitchen, dining and living area; there are two (2) designated therapy rooms, one inside the home and one located in the backyard. There is no staff room therefore awake staff is required. There is a laundry area in the facility. Fire extinguishers were observed throughout the facility; all were observed to be fully charged and last serviced on 03/19/2024. Hardwired smoke and carbon monoxide detectors were tested and all were functional at the time of the visit. Staff office and storage space is on the lower level attached garage. Medications and records will be stored in the office locked cabinet. The first aid kit was observed to be complete.

KITCHEN: Appliances and fixtures appeared clean and functional. There was sufficient emergency food and water supply to accommodate a maximum capacity of 6 clients for approximately three (3) to seven (7) days. There was sufficient dining and cook ware to accommodate a maximum capacity of 6 (six) clients. Applicants indicated knives and other sharps will be stored in locked and inaccessible to clients in care. BEDROOMS: All bedrooms had sufficient lighting; were equipped and supplied with appropriate furniture, bedding and linens. Emergency lighting observed in the hallway. BATHROOMS : Three (3) out of the four (4) bathrooms are designated for residents use. Bathrooms were supplied with appropriate hygiene products. SURROUNDING GROUNDS: The front yard includes a driveway, walkways and landscaped areas. Backyard observed with outdoor seating area, shaded area, as well as an in-ground pool. The pool is kept inaccessible to clients with the use of fencing and a locked gate. Also there is a higher level outdoor seating area for residents use above the group therapy room in the backyard. There were no visible hazards or discrepancies observed. (Continue to LIC809c).