Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the annual inspection with the focus of the Infection Control domain. LPA met with the Administrator, Sanaa Helal, who arrived at 11:45 a.m. to assist with the inspection. The facility is licensed to serve four (4) developmentally disabled adults ages 18 - 59 and approved for 4 non-ambulatory clients.

LPA toured the facility with the Administrator and observed the following:

* There are 3 client bedrooms, 3 bathrooms (2 for client use and 1 for staff), living room, dining room, family room, kitchen, laundry area, and staff rest area, and a detached garage.

* Temperature is taken upon entering the facility and is documented.

* Coronavirus (COVID-19) signage are posted throughout the facility to promote hand washing hygiene, cough/sneeze etiquette, and symptom checks.

* The facility has at least 30 days of PPE supplies in storage.

* There are sufficient food supply of 2 day perishable and a week of non-perishable.

* Knives, cleaning solutions, and disinfectants are stored and locked making them inaccessible to clients.

* Smoke detectors and a carbon monoxide detector were tested and operable.

* Medications are centrally stored and locked in the cabinet. LPA reviewed medication for all 4 clients.

Per the Administrator, they are continuing to follow the COVID-19 guidance.

No deficiencies were observed during the visit today. An exit interview was conducted and a copy of this report was provided to the Administrator.