Facility Evaluation Report

Licensing Program Analyst (LPA) Kelly Dulek arrived unannounced to conduct a required annual visit. The LPA met with Licensee Dylan Hull. LPA explained the reason for the visit. Entrance interview conducted.

Beginning at 02:25PM, the LPA, along with Licensee toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed:

Fire extinguisher is fully charged and purchased on 05/15/2023. Hardwired combination smoke/carbon monoxide detectors and fire doors were tested at 04:17 PM and were functional. A copy of the current liability insurance was obtained during today's visit.

KITCHEN : The LPA observed the kitchen to be clean. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of seven (7) days non-perishable and two (2) days perishable food. Cleaning supplies are located in a locked cabinet under the kitchen sink. Knives are stored in a locked kitchen drawer.

COMMON AREAS : This includes the living room and dining room areas. LPA observed common area to be clean and properly furnished at the time of the visit. An non-functional fireplace was noted in the living room. Adjacent to the kitchen is a laundry room, which contained locked chemical storage.

BEDROOMS : There are seven (7) total bedrooms in the facility; six (6) bedrooms are designated as private resident rooms and one (1) staff room. The staff room is kept locked. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting.