The facility is a one-story home with five bedrooms, three bathrooms, kitchen, dining room, living room, backyard, staff office and attached 2-car garage. Facility appears clean, safe and sanitary. All residents rooms had required the elements, including bed, chair, closet space and ample lighting. Facility has extra linens and hygiene supplies for clients in hallway closets. Restrooms are stocked with soap and paper towels and have hand washing postings. Hot water initially measured over 120 degrees Fahrenheit. AAD stated the facility had a new hot water heater installed the week prior. AAD adjusted the settings on the water heater. After approximately an hour,hot water measured between 105 degrees Fahrenheit and 120 degrees Fahrenheit in the bathrooms. LPA advised AAD to maintain a water log for at least two weeks to monitor the water temperature. A Technical Assistance was issued. LPA observed facility has emergency food and water supply.LPA observed hazardous items such as knives, chemicals and cleaners to be locked up in cabinets in the kitchen and the garage. Knives are locked up separate from toxic chemicals. Medication for each resident is kept locked in a cabinet in the staff office. The backyard has a shaded sitting/lounging area. Exit gates are unlocked. LPA noted bricks on the ground in front of one of the exit gates. AAD stated the bricks are there to keep the facility's dog from leaving the back yard. LPA advised AAD to find a solution that does not present a tripping hazard. A Technical Assistance was issued. LPA reviewed all four client files and three staff files. LPA also reviewed medication and P&I for all four clients. Facility has board games, exercise equipment, electronics, music and more for client use. The clients at the facility also have a dog, a cat and a hamster.