STATE OF MICHIGAN
DEPARTMENT OF HUMAN SERVICES
BUREAU OF CHILDREN AND ADULT LICENSING
JENNIFER M. GRANHOLM
ISMAEL AHMED
GOVERNOR
DIRECTOR
May 13, 2010
Marvita Jones
42 W Burnham
Battle Creek, MI 49015
RE: Application #: AF130305078
Frances Adult Foster Care
42 W Burnham
Battle Creek, MI 49015
Dear Ms. Jones:
Attached is the Original Licensing Study Report for the above referenced facility. The
study has determined substantial compliance with applicable licensing statutes and
administrative rules. Therefore, a temporary license with a maximum capacity of 2 is
issued.
Please review the enclosed documentation for accuracy and feel free to contact me with
any questions. In the event that I am not available and you need to speak to someone
immediately, please feel free to contact the local office at (269) 337-5066.
Sincerely,
Jean Skalski, LMSW, Licensing Consultant
Bureau of Children and Adult Licensing
322 E. Stockbridge Ave
Kalamazoo, MI 49001
(269) 337-5274
Enclosure
P.O. BOX 30650 • LANSING, MICHIGAN 48909-8150
www.michigan.gov • (517) 335-6124
MICHIGAN DEPARTMENT OF HUMAN SERVICES
BUREAU OF CHILDREN AND ADULT LICENSING
LICENSING STUDY REPORT
I. IDENTIFYING INFORMATION
License #:
AF130305078
Applicant Name:
Marvita Jones
Applicant Address:
42 W Burnham
Battle Creek, MI 49015
Applicant Telephone #:
(269) 589-6144
Administrator/Licensee Designee:
N/A
Name of Facility:
Frances Adult Foster Care
Facility Address:
42 W Burnham
Battle Creek, MI 49015
Facility Telephone #:
(269) 589-6144
10/02/2009
Application Date:
Capacity:
2
Program Type:
DEVELOPMENTALLY DISABLED
PHYSICALLY HANDICAPPED
ELDERLY
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II.
III.
METHODOLOGY
10/02/2009
Enrollment
10/08/2009
Application Incomplete Letter Sent
App items 45, 53 & 1326 Sharon Thompson, Responsible Person
01/05/2010
Application Complete/On-site Needed
01/08/2010
Application Incomplete Letter Sent
02/05/2010
Inspection Completed On-site
02/18/2010
Application Incomplete Letter Sent
04/15/2010
Contact - Telephone call made
PC to Facility: Keven Pugh
04/28/2010
Inspection Completed On-site
05/06/2010
Inspection Completed On-site
05/06/2010
Inspection Completed-BCAL Full Compliance
DESCRIPTION OF FINDINGS & CONCLUSIONS
A. Physical Description of Facility
Property Ownership – Marvita Jones and Helen Robinson are the owners of the
property. They have provided written documentation of ownership. Marvita has
provided a copy of her driver’s license as documentation that 42 W. Burnham is her
primary residence. Helen Robinson lives in the home next door.
Description of Facility – The facility is a small three bedroom home with a Michigan
basement located in Battle Creek within walking distance from downtown. The furnace,
water heater, washer and dryer are in the basement. There is a door leading directly
into the backyard from the basement. Residents will not be using the basement for
living space. There is one small bedroom off the front porch that is used by the licensee
and two resident bedrooms, a living room/dining room and kitchen and one full bath with
bath tub/shower.
Square footage of resident bedrooms and living space:
Bedroom #1
Bedroom #2
Living Room
Dining Room
10’ x 11’ = 110 sq. feet [plus a walk-in closet (7’2” x 2’10”)]
9’11” x 11’ = 109.12 sq. feet
12’ x 14’ = 168 sq. feet
10’ x’11’ = 110 sq. feet
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The total living space of 399 square feet (excluding bedrooms, bathrooms, and kitchen
area) meets the total minimum living space for two residents and the licensee.
Licensee has provided proof that the front bedroom paneling meets the Class C fire
rating.
When Bedroom #1 was first viewed it contained two single beds with three (3) feet in
between and the required dressers were in the walk-in closet. The total square footage
of the room, minus the walk-in closet is 110 sq. feet, 20 sq. feet short of the requirement
for double occupancy. Those 20 square feet can be found in the spacious walk-in
closet, which houses the required dressers, thereby freeing up usable floor space in the
room itself, which would seem to meet the intent of the rule. A variance allowing for
double occupancy in Bedroom #1 is being requested.
Sanitation – The home has city water and sewer as well as weekly garbage pick-up.
The kitchen is equipped with a stove, refrigerator and hot/cold water. It is
recommended that the hot water temperature to the bathrooms be monitored and not to
exceed 120 degrees Fahrenheit.
Fire Safety – The home is equipped with a minimum of one fire extinguisher on the
main floor of the home. There are two identified fire exits from the main floor. The
licensee would also like to place locking metal bars on the kitchen window that leads to
the back deck and will be requesting a variance to do so for security. There is a door to
the back deck less than two feet from the window for egress from the backside of the
home. Licensee has been informed that she cannot use the locked metal bars on the
window until such time as a variance is approved. There are smoke detectors near the
bedrooms and living areas as well as one in the basement that contains the furnace.
The basement is separated from the main floor by a fully stopped, self-closing solid core
door. Emergency procedures are posted as required. Fire drills will be checked at
renewal time to assure compliance with the fire safety rules.
B. Program Description
Marvita Jones is the sole licensee. She has identified Helen Robinson (her mother who
lives next door) and Keven Pugh (her brother) as responsible persons to assist her with
resident care as she works a full-time job, currently second shift. The licensee is aware
that residents cannot be left alone at anytime.
A completed Licensing Record Clearance Request form is contained in the record
indicating good moral character of the licensee and family members. Recent medical
clearances and proof of a negative TB test are also on file for licensee and responsible
persons. A review of the application indicates compliance with applicable rules
regarding financial capability of the licensee.
Licensee took care of her grandmother, who was confined to a wheelchair and later
bedridden, performing her personal care for almost 15 years. Responsible persons also
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have experience caring for adults: Ms. Robinson cared for her mother and has worked
with elderly adults through AARP Foundation, and Mr. Pugh is a certified nurse aide.
Licensee has developed House Guidelines which cover admissions and discharge
procedures. The licensee has indicated the desire to care for developmentally disabled
and physically handicapped and will also take elderly. Wheelchair bound residents
cannot be accommodated. Private pay and public supported residents will be accepted.
The facility is able to provide transportation for the residents to local appointments if a
relative or responsible person is unable to transport.
Smoking is prohibited on the premises.
Facility Records – All required resident records forms were reviewed with licensee and
she was given a sample packet.
C. Rule/Statutory Violations
None.
IV.
RECOMMENDATION
I recommend issuance of a temporary license to this AFC adult family home
(capacity 2).
________________________________________
Jean Skalski, LMSW
Date: 5/10/2010
Licensing Consultant
Approved By:
05/13/2010
________________________________________
Gregory V. Corrigan
Date
Area Manager
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