state: CT

facility_name: Adelbrook Community Services Benny Drive

summary: Visit conducted on December 11, 2025. Visit covered 14 main areas/topics. No compliance issues identified.

raw_content:
DCF-3034
1/2013 (Revised)
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

NAME OF FACILITY / PROGRAM: Adelbrook/Benny Drive Group Home

TIME OF VISIT (FROM - TO): 10:00am -11:20am     DATE: December 11, 2025

 AGENCY PERSONNEL WHO PARTICIPATED:

Job Title
Clinical Therapist
Program Supervisor

Areas / Topics covered during visit:

•	Census: The group home had two youths at the facility during the quarterly visit and the current license bed capacity is four.
•	Admissions: There were no new admissions in the last quarter.
•	Discharges: There was one discharge in the last quarter.
•	Staff: The group home staffing consisted of seven full-timers and five per-diem employees.
•	Staff vacancies: The program reported that it has two full-time direct care staff openings.
•	Staff hires: The group home has hired a new clinician, and her start date was October 20, 2025.
•	Medication: The program reported that it has eight medication-certified employees, and they are able to administer medication to residents across all three shifts, seven days a week.
•	Physical plant: A walkthrough of the facility was conducted with the supervisor to confirm the group home's compliance with regulatory standards.
•	Personnel files: An audit of personnel records was not conducted in this quarter.
•	SIU Reports: There were no reports in this quarter.

Corrections implemented as a result of previous visit:
N/A

Recommendations: (The following areas were not identified as regulatory non-compliance, but are recommended to be addressed in order to enhance program functioning)
N/A

Areas of regulatory non-compliance identified during this visit:
N/A

Please submit a plan of correction to address the above referenced areas of non-compliance within 30 days of receipt of this report. The plan of correction must be submitted to the attention of the undersigned at the address listed above.

Penny Woodward, LCSW                                   December 22, 2025
Regulatory Consultant                                                      Date

A COPY OF THIS SUMMARY SHOULD BE SENT TO THE EXECUTIVE DIRECTOR OF THE FACILITY / PROGRAM|

facility_name: Adelbrook/Benny Drive Group Home

visit_date: December 11, 2025

personnel:
Clinical Therapist
Program Supervisor


summary: Visit conducted on June 27, 2025. Visit covered 11 main areas/topics. No compliance issues identified.

raw_content:
DCF-3034
1/2013 (Revised)
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM: Adelbrook/Benny Drive Group Home

 TIME OF VISIT (FROM - TO): 11:30am -12:37pm            DATE: June 27, 2025

 AGENCY PERSONNEL WHO PARTICIPATED:

Job Title
Director
Assistant Director

Areas / Topics covered during visit:

•	Census: The group home has two youths at the facility and the program's bed capacity is four.
•	Admissions: There were no new admissions in the last quarter.
•	Discharges: There were no discharges in the last quarter.
•	Staff vacancies: The program has a clinician vacancy and two full-time direct care staff openings.
•	Staff hires: The group home has hired two full-time direct care staff and one per-diem employee in the last quarter.
•	Medication: The program reported that it has enough medication-certified employees to administer medication to residents on each shift, seven days a week.
•	Physical plant: A walkthrough of the facility was conducted with the director and assistant director to evaluate the group home's compliance with regulatory standards.

Corrections implemented as a result of previous visit:
N/A

Recommendations: (The following areas were not identified as regulatory non-compliance, but are recommended to be addressed in order to enhance program functioning)
N/A

Areas of regulatory non-compliance identified during this visit:
N/A

Please submit a plan of correction to address the above referenced areas of non-compliance within 30 days of receipt of this report. The plan of correction must be submitted to the attention of the undersigned at the address listed above.

Penny Woodward, LCSW                                   July 15, 2025
Regulatory Consultant                                               Date|

personnel:
Director
Assistant Director


summary: Visit conducted on 3/14/2025. Visit covered 4 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Benny Drive Group Home
 TIME OF VISIT (FROM - TO): 2:40 pm                         DATE:    3/14/2025

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Benny Drive Co-Supervisor
Benny Drive Clinician

List of Areas / Topics covered during visit:

•	Discussion of the current census, which is 2, and the LBC for Benny Drive is 4.

•	Discussion of Benny Drive's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Benny Drive staff regarding the status of the Benny Drive milieu, the clinical programming, and recreational activities.

•	Inspection of the Benny Drive physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

Patrick Hughes                                               3/17/25
Regulatory Consultant                                   Date|

facility_name: Benny Drive Group Home


summary: Visit conducted on 12/6/2024. Visit covered 5 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Benny Drive Group Home
 TIME OF VISIT (FROM - TO): 1:30 pm                         DATE:    12/6/2024

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Benny Drive Supervisor
Benny Drive Clinician

List of Areas / Topics covered during visit:

•	Discussion of the current census, which is 3, and the LBC for Benny Drive is 4.

•	Discussion of Benny Drive's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Benny Drive staff regarding the status of the Benny Drive milieu, the clinical programming, recreational activities.

•	Observations of the Benny Drive residents and observations of the interactions between Benny Drive staff and the Benny Drive residents.

•	Inspection of the Benny Drive physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

Patrick Hughes                                               12/6/24
Regulatory Consultant                                     Date|


facility_name: Adelbrook Community Services, Inc. / Esther GH

summary: Visit conducted on 6/20/2025. Visit covered 5 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Esther House
 TIME OF VISIT (FROM - TO): 1:00 pm                         DATE:    6/20/2025

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Esther House Supervisors (2)
Esther House Clinician

List of Areas / Topics covered during visit:

•	Discussion of the current census, which is 3, and the LBC for Esther House is 4.

•	Discussion of Esther House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Esther House staff regarding the status the Esther House milieu, the clinical programming, recreational activities.

•	Observations and conversation with Esther House residents and observations of the interactions between Esther House staff and the Esther House residents.

•	Inspection of the Esther House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

Patrick Hughes                                               8/5/25
Regulatory Consultant                                     Date|

facility_name: Esther House


summary: Visit conducted on 3/26/2025. Visit covered 5 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Esther House
 TIME OF VISIT (FROM - TO): 1:30 pm                         DATE:    3/26/2025

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Esther House Supervisors (2)

List of Areas / Topics covered during visit:

•	Discussion of the current census, which is 3, and the LBC for Esther House is 4.

•	Discussion of Esther House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Esther House staff regarding the status the Esther House milieu, the clinical programming, recreational activities.

•	Observations and conversation with Esther House residents and observations of the interactions between Esther House staff and the Esther House residents.

•	Inspection of the Esther House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

Patrick Hughes                                               3/28/25
Regulatory Consultant                                     Date|


summary: Visit conducted on 12/3/2024. Visit covered 5 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Esther House
 TIME OF VISIT (FROM - TO): 1:00 pm                         DATE:    12/3/2024

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Esther House Supervisors (2)

List of Areas / Topics covered during visit:

•	Discussion of the current census, which is 3, and the LBC for Esther House is 4. One resident is currently hospitalized.

•	Discussion of Esther House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Esther House staff regarding the status the Esther House milieu, the clinical programming, recreational activities, and the beginning of the school year.
•	Observations and conversation with Esther House residents and observations of the interactions between Esther House staff and the Esther House residents.

•	Inspection of the Esther House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

Patrick Hughes                                               12/5/24
Regulatory Consultant                                   Date|


summary: Visit conducted on 8/21/2024. Visit covered 5 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Esther House
 TIME OF VISIT (FROM - TO): 12:30 pm                         DATE:    8/21/2024

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Adelbrook Director of Group Homes
Esther House Supervisors (2)

List of Areas / Topics covered during visit:

•	Discussion of the current census, which is 3, and the LBC for Esther House is 4. One resident is currently hospitalized.

•	Discussion of Esther House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Esther House staff regarding the status the Esther House milieu, the clinical programming, recreational activities, and the beginning of the school year.
•	Observations and conversation with Esther House residents and observations of the interactions between Esther House staff and the Esther House residents.

•	Inspection of the Esther House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

Patrick Hughes                                              8/23/24
Regulatory Consultant                                   Date|


raw_content:
June 13, 2024

Alyssa Goduti / President & CEO
Adelbrook Community Services Inc.
60 Hicksville Road
Cromwell, CT 06416

RE: CCF # 88 Esther House

Dear Ms. Goduti,

We conducted a relicensing visit of your agency's program on May 8th and May 10th. This inspection determined your agency's program is in compliance with the Regulations for the Operation of Child Caring Agencies and Facilities; Sections 17a-145-48 through 17a-145-98, as well as DCF Guidelines for the Administration of Medication by Certified Staff.

The Department has determined that your agency has met the requirements for a regular license. This license is effective as of August 16, 2024, and is valid for twenty-four months. We thank you and your staff for your cooperative participation in the review process.

Sincerely,
Patrick Hughes

Patrick Hughes
Regulatory Consultant
Department of Children and Families
505 Hudson Street
Hartford, CT  06106
(p) 860-550-6552
(c) 860-716-2199
patrick.hughes@ct.gov|

report_type: unstructured


summary: Visit conducted on 3/27/2024. Visit covered 5 main areas/topics. No compliance issues identified.

raw_content:
DCF-3034
6/2021 (Revised)
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Esther House
 TIME OF VISIT (FROM - TO): 1:00 pm                         DATE:    3/27/2024

AGENCY PERSONNEL WHO PARTICIPATED:

Job Title
Adelbrook Director of Group Homes
Esther House Supervisors
Esther House Clinician

List of Areas / Topics covered during visit:

•	Discussion of the current census, which is 2, and the LBC for Esther House is 4.

•	Discussion of Esther House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Esther House staff regarding the status the Esther House milieu, the clinical programming, recreational activities, and the residents' school programs.

•	Observations and conversation with Esther House residents and observations of the interactions between Esther House staff and the Esther House residents.

•	Inspection of the Esther House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

Patrick Hughes                                              4/1/24|


summary: Visit conducted on 11/27/2023. Visit covered 4 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Esther House
 TIME OF VISIT (FROM - TO): 9:30 pm to 1:00 pm                         DATE:    11/27/2023

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Adelbrook Director of Group Homes
Assistant Director of Group Homes

List of Areas / Topics covered during visit:

•	Discussion of the current census, which is 2, and the LBC for Esther House is 4.

•	Discussion of Esther House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Esther House staff regarding the status the Esther House milieu, the clinical programming, recreational activities, and the residents' school programs.

•	Inspection of the Esther House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

Patrick Hughes                                              12/21/23|


summary: Visit conducted on 9/28/2023. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

                                                  Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than thee bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Esther House
 TIME OF VISIT (FROM - TO): 2:30 pm to 3:30 pm                         DATE:    9/28/2023

AGENCY PERSONNEL WHO PARTICIPATED:
Job Titles

Esther House Supervisor (2)
Esther House Clinician

List of Areas / Topics covered during visit:

	Discussion of the current census, which is 1, and the LBC for Esther House is 4.

	Discussion of Esther House's current staffing levels, vacant positions, and hiring activities.

	Discussion with Esther House staff regarding the status the Esther House milieu, the clinical programming, recreational activities and the beginning of the new school year for the residents.

	Inspection of the Esther House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

        Not applicable.

Areas of regulatory non-compliance identified during this visit:

       None at the time of this quarterly visit.

Patrick Hughes                                              9/28/23
Regulatory Consultant                                      Date|


summary: Visit conducted on 6/26/2023. Visit covered 4 main areas/topics. No compliance issues identified.

raw_content:
Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Esther House
 TIME OF VISIT (FROM - TO): 1:00 pm to 2:30 pm                         DATE:    6/26/2023

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Esther House Direct Care Staff

List of Areas / Topics covered during visit:

•	Discussion of the current census, which is 1, and the LBC for Esther House is 4.

•	Discussion of Esther House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Esther House staff regarding the status of Esther House's milieu, the clinical programming, and summer activities for the residents.

•	Inspection of the Esther House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

Patrick Hughes                                              6/26/23
Regulatory Consultant                                   Date|


summary: Visit conducted on 3/15/2023. Visit covered 5 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Esther House
 TIME OF VISIT (FROM - TO): 12:45 pm to 1:45 pm                         DATE:    3/15/2023

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Adelbrook Director of Group Homes
Esther House Supervisor

List of Areas / Topics covered during visit:

•	Discussion of the current census, which is 2, with 1 resident currently hospitalized and the LBC for Esther House is 4.

•	Discussion of Esther House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Esther House staff regarding the status of Esther House's milieu, the clinical programming, and activities for the residents.

•	Observations and discussion with the 1 resident home at the time of this quarterly visit, and observations of the interactions between Esther House staff and the Esther House resident.

•	Inspection of the Esther House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

Patrick Hughes                                              3/21/23
Regulatory Consultant                                   Date|


summary: Visit conducted on 12/28/2022. Visit covered 5 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

  NAME OF FACILITY / PROGRAM:   Esther House

 TIME OF VISIT (FROM - TO):   3:30pm                      DATE:      12/28/2022

 AGENCY PERSONNEL WHO PARTICIPATED:

Name	Job Title
ND   	Director of Group Homes
NY   	Esther House co-supervisor

List of Areas / Topics covered during visit:

•	Current census is 2 and the licensed bed capacity is 4. One resident is currently hospitalized. There was one discharge this quarter to a DMHAS program. There is one pending referral for Esther House.
•	The one resident currently in Esther House is doing well and preparing to discharge home to her mother.
•	Currently Esther House is fully staffed with no vacant positions.
•	Observation of the residents in the milieu; The one resident home was having free time at the time of the visit. The Esther resident reported to be doing well and is very excited to be discharging home in the next few weeks. She reported the Esther House staff are nice to her and treat her well.
•	Physical plant inspection of the facility; Esther House was clean, organized and nicely decorated with no health or safety concerns observed.

Corrective Actions implemented as a result of previous visit:

•	Not applicable

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

Patrick Hughes                                              2/8/2023
Regulatory Consultant                                   Date

A COPY OF THIS SUMMARY SHOULD BE SENT TO THE EXECUTIVE DIRECTOR OF THE FACILITY / PROGRAM|


summary: Visit conducted on 9/26/2022. Visit covered 5 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

  NAME OF FACILITY / PROGRAM:   Esther House

 TIME OF VISIT (FROM - TO):   1:00pm                      DATE:      9/26/2022

 AGENCY PERSONNEL WHO PARTICIPATED:

Name	Job Title
ND	Director of Group Homes
NY	Esther House co-supervisor

List of Areas / Topics covered during visit:

•	Current census is 3 and the licensed bed capacity is 4. One resident who was briefly hospitalized (5days) has returned to Esther House.
•	The residents of Esther House are doing well individually and as a group. The girls are out in the community often and have recently attended the Big E, the Durham Fair, and the Bristol Mum Fair.
•	Currently Esther House is fully staffed with no vacant positions.
•	Physical plant inspection of the facility; Esther House was clean, organized and nicely decorated with no health or safety concerns observed.
•	Observation of the residents in the milieu; two residents were home at the time of this quarterly visit. Both girls reported they were doing well and reported the staff at Esther House are nice. One resident reported she recently had her senior pictures taken and was very excited about this. Both residents appeared comfortable in their surrounding and all interactions between the staff and residents were friendly and professional.

Corrective Actions implemented as a result of previous visit:

•	Not applicable

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

Patrick Hughes                                              9/26/22
Regulatory Consultant                                   Date

A COPY OF THIS SUMMARY SHOULD BE SENT TO THE EXECUTIVE DIRECTOR OF THE FACILITY / PROGRAM|


raw_content:
June 6, 2022

Alyssa Goduti / President & CEO
Adelbrook Community Services Inc.
60 Hicksville Road
Cromwell, CT 06416

RE: CCF # 88 Esther House

Dear Ms. Goduti,

We conducted a relicensing visit of your agency's program on June 1, 2022. This inspection determined your agency's program is in compliance with the Regulations for the Operation of Child Caring Agencies and Facilities; Sections 17a-145-48 through 17a-145-98, as well as DCF Guidelines for the Administration of Medication by Certified Staff.

The Department has determined that your agency has met the requirements for a regular license. This license is effective as of August 16, 2022 and is valid for twenty-four months. We thank you and your staff for your cooperative participation in the review process.

Sincerely,
Patrick Hughes

Patrick Hughes
Regulatory Consultant
Department of Children and Families
505 Hudson Street
Hartford, CT  06106
(p) 860-550-6552
(f) 860-550-6665
patrick.hughes@ct.gov|


facility_name: Adelbrook Community Services, Inc./ Isaiah / GH

summary: Visit conducted on 11/25/2025. Visit covered 5 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Isaiah House

TIME OF VISIT (FROM - TO): 2:15 pm                      DATE:    11/25/2025

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Isaiah House Co-Supervisor
Isaiah House Direct Care Worker

List of Areas / Topics covered during visit:

•	Discussion of the current census, which is 4, and the LBC is 4.

•	Discussion of Isaiah House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Isaiah House staff regarding the status the Isaiah House milieu, the clinical programming, recreational activities.

•	Inspection of the Isaiah House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

•	At the time of this visit the residents had not returned from their school programs.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

 Patrick Hughes                                              11/25/25
Regulatory Consultant                                   Date|

facility_name: Isaiah House


summary: Visit conducted on 9/16/2025. Visit covered 5 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Isaiah House

TIME OF VISIT (FROM - TO): 3:00 pm                      DATE:    9/16/2025

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Isaiah House Co-Supervisor
Isaiah House Direct Care Worker

List of Areas / Topics covered during visit:

•	Discussion of the current census, which is 4, and the LBC is 4.

•	Discussion of Isaiah House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Isaiah House staff regarding the status the Isaiah House milieu, the clinical programming, recreational activities.

•	Inspection of the Isaiah House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

•	At the time of this visit the residents had not returned from their school programs.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

 Patrick Hughes                                              9/16/25
Regulatory Consultant                                   Date|


raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Isaiah House

TIME OF VISIT (FROM - TO): 3:00 pm                      DATE:    6/20/2025

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Isaiah House Co-Supervisor
Isaiah House Direct Care Worker

List of Areas / Topics covered during visit:

•	Discussion of the current census, which is 2, and the LBC is 4.

•	Discussion of Isaiah House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Isaiah House staff regarding the status the Isaiah House milieu, the clinical programming, recreational activities.

•	Inspection of the Isaiah House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

•	At the time of this visit the residents were off grounds at Lake Compounce.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

 Patrick Hughes                                              6/20/25
Regulatory Consultant                                    Date|


summary: Visit conducted on 3/26/2025. Visit covered 4 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Isaiah House

TIME OF VISIT (FROM - TO): 2:30 pm                      DATE:    3/26/2025

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Isaiah House Co-Supervisor
Isaiah House Direct Care Worker

List of Areas / Topics covered during visit:

•	Discussion of the current census, which is 2, and the LBC is 4.

•	Discussion of Isaiah House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Isaiah House staff regarding the status the Isaiah House milieu, the clinical programming, recreational activities.

•	Inspection of the Isaiah House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

 Patrick Hughes                                              3/28/25
Regulatory Consultant                                     Date|


summary: Visit conducted on 12/3/2024. Visit covered 4 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Isaiah House
 TIME OF VISIT (FROM - TO): 1:45                     DATE:    12/3/2024

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Isaiah House Supervisor
Isaiah House direct care worker

List of Areas / Topics covered during visit:

•	Discussion of the current census, which is 1, and the LBC is 4.

•	Discussion of Isaiah House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Isaiah House staff regarding the status of Isaiah House's milieu, the clinical programming, the beginning of the school year and the scheduled activities for the residents.

•	Inspection of the Isaiah House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

 Patrick Hughes                                              12/6/24
Regulatory Consultant                                     Date|


summary: Visit conducted on 8/21/2024. Visit covered 6 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Isaiah House
 TIME OF VISIT (FROM - TO): 1:30                      DATE:    8/21/2024

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Adelbrook Director of Group Homes
Isaiah House Supervisor

List of Areas / Topics covered during visit:

•	Discussion of the current census, which is 2, and the LBC is 4. One resident is currently hospitalized.

•	Discussion of Isaiah House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Isaiah House staff regarding the status of Isaiah House's milieu, the clinical programming, the beginning of the school year and the scheduled activities for the residents.

•	Observation of the Isaiah House resident home at the time of this quarterly visit.

•	Brief discussion with the 1 Isaiah House resident present at the time of the visit regarding her experiences at the group home.

•	Inspection of the Isaiah House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

 Patrick Hughes                                              8/23/24
Regulatory Consultant                                   Date|


summary: Visit conducted on 6/17/2024. Visit covered 6 main areas/topics. No compliance issues identified.

raw_content:
Isaiah House
 TIME OF VISIT (FROM - TO): 1:30                      DATE:    6/17/2024

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Adelbrook Director of Group Homes
Isaiah House Supervisor

List of Areas / Topics covered during visit:

•	Discussion of the current census, which is 2, and the LBC is 4.

•	Discussion of Isaiah House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Isaiah House staff regarding the status of Isaiah House's milieu, the clinical programming, and the scheduled activities for the residents.

•	Observation of the Isaiah House resident home at the time of this quarterly visit.

•	Brief discussion with the 2 Isaiah House residents regarding their experiences at the group home.

•	Inspection of the Isaiah House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

Patrick Hughes                                              6/24/24
Regulatory Consultant                                   Date|


raw_content:
April 4, 2024

Alyssa Goduti, President and CEO
Adelbrook
60 Hicksville Road
Cromwell, CT 06416

RE: CCF# 79   Isaiah House

Dear Ms. Goduti,

On March 12th and 13th, 2024 a biennial licensing inspection was conducted at your facility. This inspection was conducted to determine the compliance of this facility with the Regulations for Operation of Child-Caring Agencies and Facilities 17a-145-48 through 17a-145-98, as well as the DCF Guidelines for the Administration of Medication by Certified Staff. Below are the areas of regulatory non-compliance which were identified during the re-licensing inspection.

Please review the areas identified on the attached Regulatory Compliance Plan to address each area. The plan must be submitted within 30 days of receipt of this letter and should identify: 1. the steps to be taken to correct the non-compliance and 2. the date correction(s) will be completed. The areas of non-compliance are as follows:

Public Act 19-120
Evidence: One personnel file reviewed did not have a Child Protective Services background check from the previous state (FL) she resided in, within the last five (5).

Sincerely,
Patrick Hughes

Patrick Hughes
DCF Regulatory Consultant
Licensing Unit|


summary: Visit conducted on 11/20/2023. Visit covered 5 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Isaiah House
 TIME OF VISIT (FROM - TO): 1:30 to 2:30                       DATE:    11/20/2023

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Adelbrook Director of Group Homes
Isaiah House Supervisor

List of Areas / Topics covered during visit:

•	Discussion of the current census, which is 3, and the LBC is 4.

•	Discussion of Isaiah House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Isaiah House staff regarding the status of Isaiah House's milieu, the clinical programming, and the scheduled activities for the residents.

•	Observation of the 1 Isaiah House resident home at the time of this quarterly visit.

•	Inspection of the Isaiah House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

Patrick Hughes                                              12/21/23
Regulatory Consultant                                   Date|


summary: Visit conducted on August 2, 2023. Visit covered 5 main areas/topics. No compliance issues identified.

raw_content:
6/2021 (Revised)
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Isaiah House
 TIME OF VISIT (FROM - TO): 1:00 pm to 2:30 pm                         DATE:    August 2, 2023

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Adelbrook Director of Group Homes
Isaiah House Supervisor

List of Areas / Topics covered during visit:

•	Discussion of the current census, which is 3, and the LBC is 4.

•	Discussion of Isaiah House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Isaiah House staff regarding the status of Isaiah House's milieu, the clinical programming, and summer activities for the residents.

•	Observations and conversation with Isaiah House residents and observations of the interactions between Isaiah House staff and the Isaiah House residents.

•	Inspection of the Isaiah House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

Patrick Hughes                                              8/7/23
Regulatory Consultant                                   Date|

visit_date: August 2, 2023


summary: Visit conducted on 5/10/2023. Visit covered 4 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Isaiah House
 TIME OF VISIT (FROM - TO): 2:00 pm to 3:30 pm                         DATE:    5/10/2023

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Adelbrook Director of Group Homes
Isaiah House Direct Care Staff

List of Areas / Topics covered during visit:

•	Discussion of the current census, which is 1, and the LBC is 4.

•	Discussion of Isaiah House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Isaiah House staff regarding the status of Isaiah House's milieu, the clinical programming, and activities for the residents.

•	Inspection of the Isaiah House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

Patrick Hughes                                              5/16/23
Regulatory Consultant                                   Date|


raw_content:
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Isaiah House
 TIME OF VISIT (FROM - TO): 2:00 pm to 3:00 pm                         DATE:    3/15/2023

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Adelbrook Director of Group Homes
Isaiah House Direct Care Staff

List of Areas / Topics covered during visit:

•	Discussion of the current census, which is 1, and the LBC is 4.

•	Discussion of Isaiah House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Isaiah House staff regarding the status of Isaiah House's milieu, the clinical programming, and activities for the residents.

•	Observations and conversation with the Isaiah House resident and observations of the interactions between Isaiah House staff and the Isaiah House resident.

•	Inspection of the Isaiah House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

Patrick Hughes                                              3/21/23
Regulatory Consultant                                   Date|


summary: Visit conducted on 12/28/22. Visit covered 1 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Isaiah House

 TIME OF VISIT (FROM - TO):   2:15 pm                      DATE:      12/28/22

 AGENCY PERSONNEL WHO PARTICIPATED:
Name	Job Title
ND	Adelbrook Director of Group Homes

List of Areas / Topics covered during visit:

Current census.
The current census at Isaiah House is 1 and the licensed bed capacity is 4.
There have been 2 discharges this quarter at Isaiah House to DMHAS programs.
There is an admission scheduled for tomorrow (12/29/22).

Milieu / Resident progress.
The Isaiah House resident is doing well at Isaiah House. For clinical services and recreation activities the Potter House resident joins with the 2 other Adelbrook Group Homes.

Staffing
Isaiah House has sufficient staff to cover all shifts. There are 2 full time direct care staff openings. Isaiah House has a large pool of per-diem staff and can cover any vacant shifts when they arise.

Observations / Interviews
During this quarterly visit the lone Isaiah House resident was home and sick in bed with a cold. This regulatory consultant quickly said hello to the resident from the doorway of her bedroom. The resident said hello back and reported she was doing okay and was just resting. She did not report any concerns regarding her safety or well-being.

Physical Plant Inspection
All areas of Isaiah House were observed during this quarterly visit.
Isaiah House was clean, orderly, and nicely decorated with no health or safety concerns noted.

Corrective Actions implemented as a result of previous visit:
Not applicable
Areas of regulatory non-compliance identified during this visit:
None at the time of this quarterly visit.

 Patrick Hughes                                              2/8/23
Regulatory Consultant                                   Date|


summary: Visit conducted on 9/26/22. Visit covered 1 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Isaiah House

 TIME OF VISIT (FROM - TO):   2:30 pm                      DATE:    9/26/22

 AGENCY PERSONNEL WHO PARTICIPATED:
Name	Job Title
ND	Adelbrook Director of Group Homes

List of Areas / Topics covered during visit:

Current census.
The current census at Isaiah House is 2 and the licensed bed capacity is 4.  There was one discharge this quarter with the resident moving to therapeutic foster care. There was also a new voluntary admission to Isaiah House during this quarter. There are no current referrals for the open Isaiah House beds.

Milieu / Resident progress.
The long-term Isaiah House resident is doing well at Isaiah House, and the newly admitted Isaiah House resident has been doing better of late. The residents have been out in the community often for recreation and therapeutic activities. The newly admitted Isaiah House resident has an assigned DMHAS worker who is assisting Isaiah House with finding a school placement for the new resident.

Staffing
Hiring has improved for Isaiah House over the last quarter. There are 2 full time direct care staff openings. Isaiah House has a pool of per-diem staff and are able to cover any vacant shifts.

Observations / Interviews
During this quarterly visit both residents (K & A) were home and having free time in the living/ dining room area.  This regulatory consultant spoke with both residents.  Resident K reported to be doing well and was very happy and proud of her new haircut.  She reported she is treated well by the Isaiah staff and denied any concerns for her safety or well-being.  Resident K was a little shy, but she reported to be doing well at Isaiah House and reported the staff are nice to her. She did not report any concerns for her safety or well-being. During this quarterly visit both residents appeared comfortable in their surroundings and all interactions observed were friendly.

Physical Plant Inspection
All areas of Isaiah House were observed during this quarterly visit.
Isaiah House was clean, orderly, and nicely decorated with no health or safety concerns noted.

Corrective Actions implemented as a result of previous visit:
Not applicable

Areas of regulatory non-compliance identified during this visit:
None at the time of this quarterly visit.

 Patrick Hughes                                              9/26/22
Regulatory Consultant                                   Date|


summary: Visit conducted on 6/1/2022. Visit covered 7 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Isaiah House

 TIME OF VISIT (FROM - TO):   2:30pm                      DATE:    6/1/2022

 AGENCY PERSONNEL WHO PARTICIPATED:
Name	Job Title
ND  	Adelbrook Director of Group Homes

List of Areas / Topics covered during visit:

•	Current census is 2 and the licensed bed capacity is 4.  There has been 1 discharge since the last quarterly visit. There is 1 pending referral for Isaiah House.
•	Discussed progress of the 2 Isaiah House residents and the status of the Isaiah House milieu. Both residents are doing well at Isaiah House recently the girls are participating in events and activities with the residents from the other 2 Adelbrook group homes. The most recent activity is weekly group swimming lessons.
•	Discussed Isaiah House employment vacancies and hiring updates. Hiring has improved for Isaiah House with most positions filled. Isaiah has a pool of per-diem staff to cover the vacant shifts.
•	Physical plant inspection of the facility; The group home was neat and orderly with no health or safety concerns noted.
•	Observation of the residents in the milieu; 1 resident was home, while the other resident was at a medical appointment. The one resident who was home was walking on the treadmill in the living room off the kitchen, supervised by an Isaiah House staff. She reported she is doing well at Isaiah House and that school gets out on June 20th. This resident appeared comfortable in her surroundings and did not report any concerns for her safety or well-being.

Corrective Actions implemented as a result of previous visit:

•	Not applicable

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

 Patrick Hughes                                              6/7/22
Regulatory Consultant                                   Date|


facility_name: Adelbrook- Potter's House

raw_content:
May 19, 2025

Alyssa Goduti / President & CEO
Adelbrook Community Services Inc.
60 Hicksville Road, Cromwell, CT 06416

RE: CCF # 66 Potter House

Dear Ms. Goduti,

We conducted a relicensing visit of your agency's program on April 29th and May 16th, 2025. This inspection determined your agency's program is in compliance with the Regulations for the Operation of Child Caring Agencies and Facilities; Sections 17a-145-48 through 17a-145-98, as well as DCF Guidelines for the Administration of Medication by Certified Staff.

The Department has determined that your agency has met the requirements for a regular license. This license is effective as of June 20, 2025, and is valid for twenty-four months. We thank you and your staff for your cooperative participation in the review process.

Sincerely,
Patrick Hughes

Patrick Hughes
Regulatory Consultant
Department of Children and Families
860-550-2199(w) 860-716-2199(c)|


summary: Visit conducted on March 26, 2025. Visit covered 5 main areas/topics. No compliance issues identified.

raw_content:
DCF-3034
6/2021 (Revised)

Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Potter House
 TIME OF VISIT (FROM - TO):  3:15                        DATE:    March 26, 2025

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Potter House Co-Supervisor
2 Potter Direct Care Staff

List of Areas / Topics covered during visit:

•	Discussion of the current census which is 4 and the LBC is 4.

•	Discussion of Potter House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Potter House staff regarding the status the Potter House milieu, the clinical programming, recreational activities.

•	Observations and conversation with Potter House residents and observations of the interactions between Potter House staff and the Potter House residents.

•	Inspection of the Potter House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

 Patrick Hughes                                               3/28/25
Regulatory Consultant                                      Date|

facility_name: Potter House


summary: Visit conducted on December 3, 2024. Visit covered 4 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Potter House
 TIME OF VISIT (FROM - TO):  2:45 pm                         DATE:    December 3, 2024

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Potter House Supervisor
Potter Direct Care Staff

List of Areas / Topics covered during visit:

•	Discussion of the current census (4) and the LBC is 4.

•	Discussion of Potter House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Potter House staff regarding the status of Potter House's milieu, and clinical programming.

•	Inspection of the Potter House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

 Patrick Hughes                                              12/6/24
Regulatory Consultant                                Date|

visit_date: December 3, 2024


summary: Visit conducted on August 21, 2024. Visit covered 6 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Potter House
 TIME OF VISIT (FROM - TO):  2:15 pm                         DATE:    August 21, 2024

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Potter House Supervisor
Potter House Clinician

List of Areas / Topics covered during visit:

•	Discussion of the current census (4) and the LBC is 4.

•	Discussion of Potter House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Potter House staff regarding the status of Potter House's milieu, the clinical programming, and the beginning of the school year.

•	Observations and conversation with Potter House residents and observations of the interactions between Potter House staff and the Potter House residents.

•	Brief discussion with Potter House residents about their experiences at the group home.

•	Inspection of the Potter House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

 Patrick Hughes                                              8/23/24
Regulatory Consultant                                   Date|


summary: Visit conducted on June 17, 2024. Visit covered 6 main areas/topics. No compliance issues identified.

raw_content:
Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Potter House
 TIME OF VISIT (FROM - TO):  2:30 pm                         DATE:    June 17, 2024

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Adelbrook Director of Group Homes
Potter House Supervisor

List of Areas / Topics covered during visit:

•	Discussion of the current census (4) and the LBC is 4.

•	Discussion of Potter House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Potter House staff regarding the status of Potter House's milieu, the clinical programming, and summer activities for the residents.

•	Observations and conversation with Potter House residents and observations of the interactions between Potter House staff and the Potter House residents.

•	Brief discussion with Potter House residents about their experiences at the group home.

•	Inspection of the Potter House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

 Patrick Hughes                                              6/27/24
Regulatory Consultant                                   Date|


summary: Visit conducted on March 27, 2024. Visit covered 5 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Potter House
 TIME OF VISIT (FROM - TO):  2:15 pm                         DATE:    March 27, 2024

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Adelbrook Director of Group Homes
Potter House Supervisor

List of Areas / Topics covered during visit:

•	Discussion of the current census (4) and the LBC is 4.

•	Discussion of Potter House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Potter House staff regarding the status of Potter House's milieu, the clinical programming, and summer activities for the residents.

•	Observations and conversation with Potter House residents and observations of the interactions between Potter House staff and the Potter House residents.

•	Inspection of the Potter House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

Patrick Hughes                                              4/1/24
Regulatory Consultant                                   Date|


summary: Visit conducted on November 20, 2023. Visit covered 5 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Potter House
 TIME OF VISIT (FROM - TO): 2:45 pm to 3:45 pm                         DATE:    November 20, 2023

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Adelbrook Director of Group Homes
Potter House Supervisor

List of Areas / Topics covered during visit:

•	Discussion of the current census (3) and the LBC is 4.

•	Discussion of Potter House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Potter House staff regarding the status of Potter House's milieu, the clinical programming, and summer activities for the residents.

•	Observations and conversation with Potter House residents and observations of the interactions between Potter House staff and the Potter House residents.

•	Inspection of the Potter House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

Patrick Hughes                                              12/21/23
Regulatory Consultant                                   Date|

visit_date: November 20, 2023


raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Potter House
 TIME OF VISIT (FROM - TO): 2:45 pm to 4:00 pm                         DATE:    August 2, 2023

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Adelbrook Director of Group Homes
Potter House Supervisor

List of Areas / Topics covered during visit:

•	Discussion of the current census (4), and the LBC is 4.

•	Discussion of Potter House's current staffing levels, vacant positions, and hiring activities.

•	Discussion with Potter House staff regarding the status of Potter House's milieu, the clinical programming, and summer activities for the residents.

•	Observations and conversation with Potter House residents and observations of the interactions between Potter House staff and the Potter House residents.

•	Inspection of the Potter House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

Patrick Hughes                                              8/8/23
Regulatory Consultant                                   Date|


raw_content:
May 15, 2023

Alyssa Goduti / President & CEO
Adelbrook Community Services Inc.
60 Hicksville Road
Cromwell, CT 06416

RE: CCF # 66 Potter House

Dear Ms. Goduti,

We conducted a relicensing visit of your agency's program on May 8th and May 10th. This inspection determined your agency's program is in compliance with the Regulations for the Operation of Child Caring Agencies and Facilities; Sections 17a-145-48 through 17a-145-98, as well as DCF Guidelines for the Administration of Medication by Certified Staff.

The Department has determined that your agency has met the requirements for a regular license. This license is effective as of June 20, 2023, and is valid for twenty-four months. We thank you and your staff for your cooperative participation in the review process.

Sincerely,
Patrick Hughes

Patrick Hughes
Regulatory Consultant
Department of Children and Families
505 Hudson Street
Hartford, CT  06106
(p) 860-550-6552
(f) 860-550-6665
patrick.hughes@ct.gov|


summary: Visit conducted on 3/15/2023. Visit covered 5 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Potter House
 TIME OF VISIT (FROM - TO): 3:10 pm   4:15pm                         DATE:    3/15/2023

AGENCY PERSONNEL WHO PARTICIPATED:
Job Title
Adelbrook Director of Group Homes
Potter House Supervisor
Potter House Direct Care Worker

List of Areas / Topics covered during visit:

•	Discussion of the current census which is 3 and the LBC is 4.

•	Discussion of Potter House's current staffing levels, vacant positions, hiring activities.

•	Discussion with Potter House staff regarding the status of Potter House's milieu, and the clinical programming and activities for the residents.

•	Observations and discussions with the 3 residents of Potter House, and observations of interactions between the residents as well as the interactions between Potter House staff and residents.

•	Inspection of the Potter House physical plant to assess the cleanliness of the home, as well as to ensure there are no health or safety concerns.

Corrective Actions implemented as a result of previous visit:

•	Not applicable.

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

Patrick Hughes                                              3/20/23
Regulatory Consultant                                   Date|


summary: Visit conducted on 12/28/2022. Visit covered 7 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Potter House
 TIME OF VISIT (FROM - TO):   3:30 pm                      DATE:    12/28/2022
 AGENCY PERSONNEL WHO PARTICIPATED:
Name	Job Title
ND	Adelbrook Director of Group Homes

List of Areas / Topics covered during visit:

•	Current census is 1 and the licensed bed capacity is 4.  There are 2 current referrals for Potter House, one referral is currently at the Adelbrook residential program, while the other is currently at Susan Wayne Center.  Once their school placements have been finalized admission dates can be scheduled.
•	The lone resident at the Potter House group home is doing well. For clinical services and recreation activities the Potter House resident joins with the 2 other Adelbrook Group Homes.
•	Potter House currently has a good level of staffing. There are two fulltime direct care vacancies. One of the former employees has moved to a per-diem position with Potter House.
•	At the time of this licensing visit the 1 Potter House resident was home relaxing having free time. This regulatory consultant spoke with her, and she reported to be doing well at Potter House and is treated nicely by the Potter House staff. She did not have any concerns for her safety or well-being.
•	Physical plant inspection of the facility; The group home was neat, orderly, and well decorated with no health or safety concerns noted.

Corrective Actions implemented as a result of previous visit:

•	Not applicable

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

 Patrick Hughes                                              2/8/23
Regulatory Consultant                                   Date|


summary: Visit conducted on 09/26/2022. Visit covered 7 main areas/topics. No compliance issues identified.

raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Potter House
 TIME OF VISIT (FROM - TO):   3:45 pm                      DATE:    09/26/2022
 AGENCY PERSONNEL WHO PARTICIPATED:
Name	Job Title
ND      	Adelbrook Director of Group Homes

List of Areas / Topics covered during visit:

•	Current census is 1 and the licensed bed capacity is 4.  There are 2 current referrals for Potter House that need to have their school placements finalized before an admission date can be scheduled. One longtime resident was discharged to a DMHAS young adult program this quarter.
•	Currently there is only 1 resident in the Potter House group home.  This resident is doing well at Potter House.  For clinical services and recreation activities the Potter House resident joins with the 2 other Adelbrook Group Homes.
•	Potter House has filled the vacant co-supervisor and vacant clinician Potter House has 1 vacant full time direct care position and 1 vacant awake overnight position.
•	At the time of this licensing visit the 1 Potter House resident was home relaxing having free time. This regulatory consultant spoke with her, and she reported to be doing well at Potter House and is treated nicely by the Potter House staff. She did not have any concerns for her safety or well-being.  During this quarterly visit all interactions observed between staff and the Potter House resident were friendly and professional.
•	Physical plant inspection of the facility; The group home was neat, orderly, and well decorated with no health or safety concerns noted.

Corrective Actions implemented as a result of previous visit:

•	Not applicable

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

 Patrick Hughes                                               9/26/22
Regulatory Consultant                                   Date|

personnel: ND      	Adelbrook Director of Group Homes


raw_content:
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

 NAME OF FACILITY / PROGRAM:   Potter House
 TIME OF VISIT (FROM - TO):   3:45pm                      DATE:    6/1/2022
 AGENCY PERSONNEL WHO PARTICIPATED:
Name	Job Title
ND	Adelbrook Director of Group Homes

List of Areas / Topics covered during visit:

•	Current census is 2 and the licensed bed capacity is 4.  There are 2 current referrals for the open beds at Potter House.
•	Discussed progress of the 2 Potter House residents and the status of the Potter House milieu. Both residents are doing well overall at Potter House, however one resident is scheduled to discharge in the coming weeks and is having some difficulties.  Both girls are participating in events and activities with the residents from the other 2 Adelbrook group homes. The most recent activity is weekly group swimming lessons.
•	Discussed Potter House employment vacancies and hiring updates. Hiring has improved for Potter House with most positions filled. Potter House has a pool of per-diem staff to cover the vacant shifts.
•	At the time of this licensing visit one resident was home. The resident was upset and kept stating that she wanted to leave. This resident is scheduled to leave the group home later this month. She was unable to tell this writer why she wanted to leave but she did say she was safe and did not have any concerns for her safety or well-being.  The resident was being loud and threatening harm to the staff but did not act on this. The direct care staff and the clinician were patient, and calm as they talked with and supported the resident. By the time this writer ended the quarterly visit the resident was calm.
•	Physical plant inspection of the facility; The group home was neat and orderly with no health or safety concerns noted.
Corrective Actions implemented as a result of previous visit:

•	Not applicable

Areas of regulatory non-compliance identified during this visit:

•	None at the time of this quarterly visit.

 Patrick Hughes                                               7/6/22
Regulatory Consultant                                   Date|


facility_name: Backcountry Wellness Residential Group Home #171

summary: No compliance issues identified. Implemented 1 corrective actions.

raw_content:
DCF-3034
6/2021 (Revised)
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

NAME OF FACILITY / PROGRAM:           Backcountry Wellness Residential Group Home

TIME OF VISIT (FROM - TO) 9:40am to 10:40 am	 DATE: 3/20/26

AGENCY PERSONNEL WHO PARTICIPATED:
Job Titles:
Clinical Director

List of Areas / Topics covered during visit: This was a scheduled quarterly Licensing visit to obtain a program update and tour the physical plant.

A meeting was held with the Clinical Director. Topics discussed included:

•	LBC is 8.  Current census is 8 (8 females). Currently a waiting list.
•	Discussed current milieu.
•	Met briefly with the residents who were starting group therapy programming.
•	Discussed staffing and shift coverage.  Current Care Coach opening and part time dietician.
•	One clinician opening which will be filled by the current clinical intern.
•	No Exceptional Circumstances or AWOL behaviors.
•	Continue weekend outings to stores, pottery painting, nail salons and local restaurants.
•	In need of a new generator and washing machine.

Milieu Observation:
•	The residents were in the day room at the time this Regulatory Consultant met with them.

Physical Plant:
•	No safety concerns observed.  The entire home was clean and maintained well.

Corrective Actions implemented as a result of previous visit:
NA

Areas of regulatory non-compliance identified during this visit:
NA

Please submit a service development plan to address the above referenced areas of non-compliance within 30 days of receipt of this report.  The service development plan must be submitted to the attention of the undersigned at the address listed above. No service development plan is required for this Licensing visit.

James Funaro  				Date:    3/20/26
Regulatory Consultant

A COPY OF THIS SUMMARY SHOULD BE SENT TO THE EXECUTIVE DIRECTOR OF THE FACILITY / PROGRAM
Cc: File, Program Director|


raw_content:
12-4-25

Mr. Chase Bronfman
Chief Executive Officer
Backcountry Wellness
7 Lincoln Ave
Greenwich, CT  06830

Re: License # CCH/GH - 171

Dear Mr. Bronfman,
On 11-19 & 11-20-25, a relicensing inspection was conducted at your facility.  This inspection was conducted to determine the compliance of this program with the Regulations for the Licensure of a Child Caring Facility, Sections 17a-145-59 through 17a-145-98.  Listed below are the areas of regulatory non-compliance which were identified during the relicensing inspection.  Please review the areas identified and submit the enclosed regulation compliance plan to address each area. The plan must be submitted within 30 days of receipt of this letter and should identify: 1. the steps to be taken to correct the non-compliance and 2. the date correction(s) will be completed. The areas of non-compliance are as follows:

17a-145-86	Instructions in Safety Procedures. Supervision.
No documented fire drills completed in 2024 for Quarter 4 (1st, 2nd or 3rd shift).
No documented fire drills completed in 2025 for Quarter 1 (1st, 2nd or 3rd shift), Quarter 2 (1st or 2nd shift) and Quarter 3 (3rd shift).

17a-145-98 Case records
One discharge summary was completed more than 30 days after the client was discharged. Also, the discharge summary report form has a field "Client discharged to legal guardian:" however no information was entered into the field.
In one treatment plan the youth was admitted on 9-23-25, but did not sign the treatment plan until 10-28-25. The plan also had no guardian signature.

17a-145-64 Personnel policies and procedures
In one personnel file the physical exam was completed over 6 months before the hire date.

Once licensing has reviewed and accepted your regulation compliance plan and has determined that your agency is in compliance with the regulations, a decision on the issuance of a regular twenty-four-month license for your Child Caring Facility will be made. Until the Department makes this decision the current license will remain in effect. Failure to submit a plan within the required time frame may result in a licensing action up to and including refusal to renew a license.
Should you have any questions or comments regarding the content of this report please do not hesitate to call me at (860) 209-3136.

Sincerely,
James Funaro
REGULATORY CONSULTANT
505 Hudson Street Hartford, CT 06106
Cell Phone: 860-209-3136 |  Office Phone: 860-550-6500
505 Hudson Street Hartford, CT 06106|


summary: Visit conducted on 7/7/25. No compliance issues identified. Implemented 1 corrective actions.

raw_content:
DCF-3034
6/2021 (Revised)
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

NAME OF FACILITY / PROGRAM:           Backcountry Wellness Residential Group Home

TIME OF VISIT (FROM - TO):  9:00am to 9:45am	 DATE: 7/7/25

AGENCY PERSONNEL WHO PARTICIPATED:
Job Titles:
Care Coaches

List of Areas / Topics covered during visit: This was a scheduled quarterly Licensing visit to obtain a program update and tour the physical plant.

A meeting was held with the CEO. Topics discussed included:

•	LBC is 8.  Current census is 6 (5 girls and 1 boy)
•	Discussed summer programming (gardening, art projects and outings)
•	Discussed current milieu.
•	Met with the 6 residents eating breakfast
•	Discussed staffing and shift coverages.
•	Observed the new med-closet and new bedroom.

Milieu Observation:
•	The residents were in the dining room at the time this Regulatory Consultant met with them.

Physical Plant:
•	No safety concerns observed. The new bedroom was nicely furnished and clean.  All bedrooms and bathrooms were clean and maintained well.

Corrective Actions implemented as a result of previous visit:
NA

Areas of regulatory non-compliance identified during this visit:
NA

Please submit a service development plan to address the above referenced areas of non-compliance within 30 days of receipt of this report.  The service development plan must be submitted to the attention of the undersigned at the address listed above. No service development plan is required for this Licensing visit.

James Funaro  				Date:    7/7/25
Regulatory Consultant

A COPY OF THIS SUMMARY SHOULD BE SENT TO THE EXECUTIVE DIRECTOR OF THE FACILITY / PROGRAM
Cc: File, Program Director|


summary: Visit conducted on 5/29/25. No compliance issues identified. Implemented 1 corrective actions.

raw_content:
DCF-3034
6/2021 (Revised)
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

NAME OF FACILITY / PROGRAM:           Backcountry Wellness Residential Group Home

TIME OF VISIT (FROM - TO):  11:00am to 12:15pm	 DATE: 5/29/25

AGENCY PERSONNEL WHO PARTICIPATED:
Job Titles:
CEO

List of Areas / Topics covered during visit: This was a scheduled quarterly Licensing visit to obtain a program update and tour the physical plant.

A meeting was held with the CEO. Topics discussed included:

•	LBC is 6.  Current census is 6 with 1 intake and one discharge pending.
•	Discussed clinical, and nursing.
•	Discussed current milieu. Currently there is a waiting list.
•	Met with the 6 residents in the day/school room.
•	Discussed staffing, shift coverages and staff vacancies.
•	Discussed plans to expand the program.
•	Discussed programming and outings for the residents.

Milieu Observation:
•	The residents were in the day room at the time this Regulatory Consultant met with them.

Physical Plant:
•	No safety concerns observed.  The home is clean and maintained well.  Measured bedroom space to ensure compliance with regulations relating to potential increase in census.

Corrective Actions implemented as a result of previous visit:
NA

Areas of regulatory non-compliance identified during this visit:
NA

Please submit a service development plan to address the above referenced areas of non-compliance within 30 days of receipt of this report.  The service development plan must be submitted to the attention of the undersigned at the address listed above. No service development plan is required for this Licensing visit.

James Funaro  				Date:    5/30/25
Regulatory Consultant

A COPY OF THIS SUMMARY SHOULD BE SENT TO THE EXECUTIVE DIRECTOR OF THE FACILITY / PROGRAM
Cc: File, Program Director|


summary: Visit conducted on 3/18/25. No compliance issues identified. Implemented 1 corrective actions.

raw_content:
DCF-3034
6/2021 (Revised)
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

NAME OF FACILITY / PROGRAM:           Backcountry Wellness Residential Group Home

TIME OF VISIT (FROM - TO):  11:30am to 12:45pm	 DATE: 3/18/25

AGENCY PERSONNEL WHO PARTICIPATED:
Job Titles:
CEO/nurse

List of Areas / Topics covered during visit: This was a scheduled quarterly Licensing visit to obtain a program update and tour the physical plant.

A meeting was held with the CEO and Nurse. Topics discussed included:

•	LBC is 6.  Current census is 5 with 1 intake taking place on this day.
•	Discussed clinical, and nursing.
•	No calls to emergency services during this quarter.
•	Discussed recent discharges and current milieu. Currently there is a waiting list.
•	Met with the 5 residents during their clinical group in the day/school room.
•	Discussed staffing and shift coverages.
•	Discussed and scheduled the relicensing inspection which will occur in October 2025.

Milieu Observation:
•	The residents were in clinical group at the time this Regulatory Consultant met with them.

Physical Plant:
•	Toured the home with the Nurse. No safety concerns observed.  The home was clean and maintained well.

Corrective Actions implemented as a result of previous visit:
NA

Areas of regulatory non-compliance identified during this visit:
NA

Please submit a service development plan to address the above referenced areas of non-compliance within 30 days of receipt of this report.  The service development plan must be submitted to the attention of the undersigned at the address listed above. No service development plan is required for this Licensing visit.

James Funaro  				Date:    3/18/25
Regulatory Consultant

A COPY OF THIS SUMMARY SHOULD BE SENT TO THE EXECUTIVE DIRECTOR OF THE FACILITY / PROGRAM
Cc: File, Program Director|


summary: Visit conducted on 10/22/24. No compliance issues identified. Implemented 1 corrective actions.

raw_content:
DCF-3034
6/2021 (Revised)
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

NAME OF FACILITY / PROGRAM:           Backcountry Wellness Residential Group Home

TIME OF VISIT (FROM - TO):  11:45am to 12:30pm   	 DATE: 10/22/24

AGENCY PERSONNEL WHO PARTICIPATED:
Job Titles:
CEO/nurse/teacher

List of Areas / Topics covered during visit: This was a scheduled quarterly Licensing visit to obtain a program update and tour the physical plant.

A meeting was held with the CEO (via email) and nurse. Topics discussed included:

•	LBC is 6.  Current census is 6.
•	No calls to emergency services since last visit.
•	No discharges since last quarterly visit.
•	Discussed recreation, clinical programming, and education.
•	Discussed current milieu and staffing.

Milieu Observation:
•	Observed and talked to the residents who were in school and working on math with their teacher.

Physical Plant:
•	Toured the home with the nurse.  No safety concerns observed.  The home was clean and maintained very well.

Corrective Actions implemented as a result of previous visit:
NA

Areas of regulatory non-compliance identified during this visit:
NA

Please submit a service development plan to address the above referenced areas of non-compliance within 30 days of receipt of this report.  The Regulation Compliance Plan must be submitted to the attention of the undersigned at the address listed above. No Regulation Compliance Plan is required for this Licensing visit.

James Funaro  				Date:    10/24/24
Regulatory Consultant

A COPY OF THIS SUMMARY SHOULD BE SENT TO THE EXECUTIVE DIRECTOR OF THE FACILITY / PROGRAM
Cc: File, Program Director|


summary: Visit conducted on 9/17/24. No compliance issues identified. Implemented 1 corrective actions.

raw_content:
DCF-3034
6/2021 (Revised)
Department of Children and Families
505 Hudson Street
Hartford, CT 06106

Field Visit Reporting Form

This form is used to summarize field visits to a licensed facility or program other than the bi-annual licensing inspection. The visit may be announced or unannounced and is intended to highlight the specific items reviewed / discussed and indicate if there are specific areas where corrective action has been taken or must be taken.

NAME OF FACILITY / PROGRAM:           Backcountry Wellness Residential Group Home

TIME OF VISIT (FROM - TO):  10:45am to 11:50am   	 DATE: 9/17/24

AGENCY PERSONNEL WHO PARTICIPATED:
Job Titles:
CEO/Program Director/teacher/nurse

List of Areas / Topics covered during visit: This was a scheduled quarterly Licensing visit to obtain a program update and tour the physical plant.

A meeting was held with the CEO and Program Director. Topics discussed included:

•	LBC is 6.  Current census is 6 with 3 on a waiting list.
•	Discussed clinical, nursing and overall effectiveness and cohesion of the direct care staff.
•	No calls to emergency services during this quarter.
•	Reviewed Fire Drills for this current year.
•	Current Program Director leaving and position to be filled but there will be a prior PD covering.
•	Discussed recreation, trips into the community which are occurring on a regular basis.
•	Community Outreach Specialist that was hired has been effective in her role.

Milieu Observation:
•	Observed and talked to the residents who were in school and working with their teacher.

Physical Plant:
•	Toured the home with the CEO. No safety concerns observed.  The home was clean and maintained well.

Corrective Actions implemented as a result of previous visit:
NA

Areas of regulatory non-compliance identified during this visit:
NA

Please submit a service development plan to address the above referenced areas of non-compliance within 30 days of receipt of this report.  The service development plan must be submitted to the attention of the undersigned at the address listed above. No service development plan is required for this Licensing visit.

James Funaro  				Date:    9/19/24
Regulatory Consultant

A COPY OF THIS SUMMARY SHOULD BE SENT TO THE EXECUTIVE DIRECTOR OF THE FACILITY / PROGRAM
Cc: File, Program Director|