Facility Evaluation Report

Licensing Program Analyst (LPA) Alberto Lopez conducted unannounced visit to conduct the annual inspection and met with Staff Peter Lacsina. LPA discussed the purpose of the visit.

The facility is approved for 4 Developmentally Disabled Adults, ages 18-59 and ambulatory only. Currently there are 2 clients in care. This facility is a single-story home located in a residential area. There are 2 client bedrooms, 2 staff bedrooms, 2 bathrooms, a living room, dining room, kitchen, laundry space, and a detached garage. The following was observed:

1. Infection Control : Infection control practices and Personal Protective Equipment (PPEs) were observed. Facility is disinfecting throughout the day.

The facility is in good repair inside and outside. The living room and dining room have sufficient lighting and sitting space. The kitchen was observed clean. The medication cabinet is in the kitchen and locked. Cleaning supplies are under the kitchen's sink and kept locked. There are sufficient food supplies for at least 2 days of perishables and 7 days of non-perishables. Thermometer was observed in the freezer at 0 degrees F. Refrigerator does have a thermometer and showed 42.6 degrees which is within range. The laundry area is in the hallway. Client's bedrooms (2) were observed and have sufficient lighting, the required furniture and bedding supplies. Bathrooms (2) were observed in working condition and water temperature was tested between 127.5 – 128.8 degrees F., which is not within the required 105-120 degrees F. Backyard has a shaded sitting area. Smoke/Carbon monoxide detectors were observed, tested, and in working condition.