Facility Evaluation Report

On 01/25/23, Licensing Program Analyst (LPA) L. Salazar arrived at the facility unannounced to conduct an Annual Inspection - Infection Control. LPA was greeted by staff S1, stated the purpose of the visit and was allowed entry into the facility. LPA called Administrator via telephone, who arrived to the facility a few minutes later. Administrator certificate number 6018122735 Expiration date 06/07/24. Facility has one central entrance and exit.

Facility tour conducted. LPA observed a 5 bedroom / 2 bathroom home. One of the rooms is designated for live in staff. LPA observed 1 out of 4 residents at home during the visit. 2 of the 4 residents are currently at day program and 1 out of the 4 residents is working in the community.

LPA toured the facility kitchen and did not observe the required 7-day supply of non-perishables, however, a 2-day supply of perishables was observed. LPA observed cleaning supplies to be inaccessible in a locked cabinet in the garage. LPA observed an adequate supply of PPE and cleaning supplies. Medications checked. Medication observed in a locked cabinet in the kitchen.

LPA observed covered trash cans in bathroom and hand washing signs. Bathrooms were stocked with liquid soap and paper towels. Fire extinguisher was last serviced on 05/11/2022.

Resident bedrooms were checked. LPA observed the bedrooms to have the required furnishings and lighting. Rooms were free from odor, clutter and obstruction.