Facility Evaluation Report

Licensing Program Analysts (LPAs) Cynthia Chan and Ya-Ting Yang conducted an annual inspection with the focus of the Infection Control Practice domain. LPAs met with Staff, Tuesday Sison, who allowed entry to the facility. The purpose of the visit was explained. The facility is approved for 4 Developmentally Disabled Adults, ages 18-59 and ambulatory only. There are current 3 ambulatory clients residing at the home.

LPAs toured the facility with the staff and observed/inspected the following:

This facility is a single story home located in a residential area. There are 4 bedrooms, 2 bathrooms, living room, dining room, kitchen, laundry space, and a detached garage. There are no obstructions to the passageways or bodies of water at the facility.

There are 3 bedrooms designated for clients and 1 for live-in staff. Client rooms are equipped with the required furnishings.

The backyard has two shaded area with tables and chairs for clients use.

Covid-19 signage are posted at the facility and proper handwashing posters are present in both bathrooms. Staff screened and took the temperature of LPAs upon arrival.

Cleaning solutions are stored and locked under the kitchen sink.

Knives and medications are locked in a kitchen cabinet. Medications were reviewed for all 3 clients and did not observe any discrepancies.

Sufficient food supply of 2-day perishable and 7-day nonperishable were observed.

The fire extinguisher was last inspected on 6/17/22.

Hot water temperature was measured within the required range of 105-120 degree Fahrenheit.

No deficiencies were issued during the visit today. Exit interview was conducted and a copy of this report was given to the staff.