Facility Evaluation Report

Licensing Program Analyst (LPA) Alberto Lopez conducted the annual inspection. LPA arrived unannounced and Staff met with Administrator, Estrella "Terry Del Mundo", who assisted with the visit. The purpose of the visit was discussed. The facility is licensed to serve a total of 6 adults, of which 1 may be non-ambulatory and 5 bedridden.

There are 5 Client bedrooms, 3 bathrooms, living room, dining room, and kitchen. The laundry area is located inside the 3rd bathroom with 2 showers.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: The facility staff are using appropriate hand hygiene and gloves while assisting clients’ medications. Staff are cleaning and disinfecting throughout the day. Facility has sufficient PPE supplies and has an Infection Control Plan maintained at the facility.

Physical Plant & Environment Safety: LPA toured facility, clients’ bedrooms were checked and closet/drawer space to accommodate each client comfortably was available. The backyard is free of debris/hazards and the outdoor and passageways are free of obstruction. No bodies of water were observed at the facility. There are no security bars or weapons on the premises. Hygiene products are readily available for clients. The hot water temperature was tested in the client bathrooms and was within the required range. It measured 105.3 – 116.2 degrees F. Which is within range of 105.0 -120.0 degrees F. Storage area for cleaning solutions was unlocked and accessible to clients. Smoke detectors and carbon monoxide detectors are operable and in compliance. The fire extinguisher was observed and is fully charged. (continued on 809-C)