Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted an annual inspection with the focus of the Infection Control domain. LPA arrived unannounced and explained the purpose of the visit to the staff who allowed entry. Licensee, Sanaa Helal, arrived shortly thereafter. The facility is licensed for four (4) Ambulatory Developmentally Disabled Adults from 18-59 years old.

LPA Chan toured the facility with licensee and observed/inspected the following:

* The facility has 3 Client bedrooms, 2 Client bathrooms, living room, dining room, family room, kitchen, laundry area, staff rest area, restroom designated for staff use, and a detached garage. The detached garage space has been converted to a living space. Per licensee, it has been permitted and will be designated for a live-in staff.

* Signage such as proper hand washing, germs, and covid-19 related information are posted in the facility.

* There is a functional smoke detector in every room and one carbon monoxide detector in the house.

* The hot water temperature was measured within the range of 105-120 degree F.

* Disinfectants are stored and locked in a cabinet by the laundry room. Knives are stored and locked in a small security box in the kitchen cabinet.

* Sufficient food supply of 2-day perishable and a week of nonperishable were observed.

* There are no bodies of water or pool at the facility. No items obstructing the walkways.

* Medications were reviewed for 3 of the 4 clients and are given as prescribed.

There are no deficiencies observed during the visit. An exit interview was conducted. A copy of this report along with the appeal rights were provided.