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25 | On 09/30/24 at 2:05pm Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to conduct a 1 year required visit. LPA was greeted and granted entry by Office Manager Jennifer Powell, where LPA explained the purpose of the visit. At the time of the visit there were (2) staff and (3) clients present. The Administrator Dushawn Powell arrived shortly after.
LPA conducted a tour of the interior and exterior of the facility and observed. The facility was observed to be clean, clutter and odor free, the facility was observed to have the required postings such as CCL complaint poster, emergency disaster plan, facility sketch, and license.
Emergency Disaster drills are being conducted on a quarterly basis, the last drill was conducted on 07/14/24. The hot water was tested and found to be within regulatory limits, as the temp measured to be at 106.5 degrees Fahrenheit. The smoke and carbon monoxide detectors were tested and found to be operable. There are (3) fully charged fire extinguishers, and a safe that does contain a pellet gun.
The client files were observed to have the required documentation such as admissions agreements, medical assessments, Individual Program Plan (IPP). In addition the Personal and Incidental (P&I) funds were counted and matched the amount indicated on the P&I form. The staff files were found to have the required documentation, training, identification, and clearance forms. All staff present were observed to have obtained criminal record clearance and were observed to be associated to the facility.
The food supply was observed to be sufficient as there was a 2 day supply of perishable and a 7 day supply of non perishable food items. The medications were reviewed and Medication Authorization Record (MAR)s were reviewed and the medication are being given according to the Physician's instructions.
An exit interview was conducted and a copy of this report was provided to Administrator Dushawn Powell. |