Facility Evaluation Report

On 06/02/23 around 02:25 PM, Licensing Program Analyst (LPA) L. Holmes arrived announced to conduct a case management for a restricted healthcare condition request for Client #1 (C1) that resides at an Adult Residential Facility (ARF). LPA met with Ciara Vasquez, Program Coordinator (PC), and explained the purpose of the visit.

LPA L. Holmes conducted a joint visit with Program Clinical Consult (PCC), Witnesses (W1, W2), toured the facility with PC, interviewed staff, reviewed records, and observed the compliancy of C1's gastrostomy care. ISP, MAR and feeding schedule provided for C1.

LPA requested the following documents be submitted to CCLD by 06/09/23: for Staff members training records, license of contracted nurse, and sign-in sheet for training attendees.

Exit interview conducted and a copy of this report was provided to PC.