Facility Evaluation Report

Licensing Program Analyst (LPA) Luis Mora conducted an unannounced annual visit at the facility with focus on the infection control domain, medication and food review. LPA Mora met with Edward Cruz - Licensee and explained the reason for the visit. The facility is licensed to serve 3 ambulatory only clients ages 18-59. Facility currently has no clients.

The facility is in a residential area and it is a one story family home. A tour of the single-story facility included the office room, kitchen, dining area, living room, 2 client bedrooms, 2 bathrooms, front yard and backyard.

LPA Mora conducted the tour with Edward Cruz and observed the following: sufficient food supplies for at least 2 days of perishables and 7 days of non-perishables were observed in the kitchen. Sharps were observed locked in a kitchen cabinet. Chemical and cleaning solutions are kept locked under the kitchen sink. The First Aid kit is kept locked in the medication cabinet and it is fully stocked with all required items including a current manual. Clean towels and extra clean linen were observed in the hallway walking closet. Dining and living room have sufficient lighting and sitting area. Medications will be kept locked in a cabinet in the living room. Client and staff files will also be kept locked in the medication cabinet. All bedrooms have all required furniture, lighting, and bedding. The client bathroom was observed with shower mats. The water temperature was tested in both bathrooms and measured at 110.4 degrees F and 108.9 degrees F, which is not within the required 105-120 degrees F. A fire extinguisher was observed in the kitchen and it is fully charged. Smoke detectors were observed in each bedroom and throughout the facility and were operable during the visit. A carbon monoxide was observed in the living room. The front yard and backyard are clean. There is a shaded area with seating in the backyard. No bodies of water were observed at the facility. Passageways and exits are free of obstruction.

There are no client medication and files to review. LPA reviewed files for 2 staff and observed no deficiencies. LPA observed administrator certificate for Edward Cruz - 6044600735 with an expiration date of 06/05/2023.