Facility Evaluation Report

On 06/20/24, Licensing Program Analyst (LPA) L. Salazar arrived at the facility unannounced to conduct the required annual inspection. LPA was greeted by Program Coordinator, stated the purpose of the visit, and was allowed entry into the facility.

LPA toured the facility inside and out. An updated Infection Control plan was received prior to LPA's inspection. LPA observed the facility to be clean and free from odor. Facility temperature measured at 74 degrees F. Disinfectants and cleaning supplies were observed to be locked in a janitor closet and inaccessible to clients.

Emergency disaster plan and procedures are in place. Last fire drill was conducted on 5/2024. Doors and passageways were observed to be free from obstruction throughout the program. Fire extinguishers were observed with an expiration date 04/23/24. Client and staff files will be reviewed at a later date because the main office is closed and clients have left the program with the exception of 4 individual.

LPA requested the following updated forms to be faxed to CCLD by 7/05/24: Designation of Facility Responsibility (LIC308), Administrative Organization (LIC309), Personnel Report (LIC 500), Client Roster (LIC 9020) that identifies which individuals resident in an Intermediate Care Facility (ICF's), and Emergency Disaster Plan (LIC 610D). No deficiencies cited on today's visit.