16: Announced Visit: Pre-Licensing Inspection Copy

Facility Type: 730/733 (Group Home)

Investigation Findings
On this date a pre-licensing inspection was conducted by Licensing Program Analysts along with Licensing Program Manager and facility Administrator/CEO. There are no clients placed in the program at this time. The program will serve a capacity of ten (10) female clients ages 11-18.

The building is a single story structure with an outside sitting area, there are four offices for staff use and storage of medications. Upon entering the building to the left is staff offices, living room area, four bedrooms run along the back of the building, kitchen and dining area sit in the center of the building with a den area to the right. To the right front of the facility is bedroom #5 with its own bathroom. A tour of the facility was conducted.

Five bedrooms each having two twin beds, built in dresser drawers, closet, smoke detector.

There is a full bathroom between each two bedrooms, with bedroom #5 having its own bathroom. Water temperature was checked in each bathroom and tested at 110 degrees with bathroom #5 having tested at 100 degrees.

Sharps and cleaning supplies are stored in a locked cabinet in the main living area.

Medications are stored in a locked closet located in a staff office.

There is one large fire extinguisher located near the kitchen area and one near the office area.

There are eight (8) smoke detectors, one in each bedroom, dining room, living room, and den. There are two (2) carbon monoxide detectors one in the living room area and one in the den area.

There is indoor and outdoor activity area for the clients.

There is additional storage in the den, living room, and staff office areas.

Linens are kept in the storage area near staff office.

There were perishable and non-perishable food items in the kitchen area.

There was adequate dishware and serving utensils in the kitchen area. There was a working dishwasher in the kitchen area as well as a washer and dryer in the laundry room off the kitchen.

There is a menu posted in the kitchen.

The following corrections need to be made:
Light bulbs need to be replaced in bathrooms #1, 2, and 3.
Sink in bathroom #2 is plugged.
Water temperature in bathroom #5 is at 100 degrees, needs to be set between 105 and 120 degrees.

Administrator submitted a waiver request for the use of video cameras for this facility.

During the Pre-Licensing Inspection Component III was conducted. Licensing Program Analyst was given a current LIC 500 for this facility. Facility will need to make the above corrections before a provisional license can be issued. Once completed the facility file will be submitted for review and a provisional license will be issued. Exit interview was conducted and a copy of this report was given to the licensee.


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