Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the annual inspection. LPA arrived unannounced and met with licensee, Jesusa Viloria. The purpose of the visit was explained. The facility is licensed to serve (6) mentally disabled adults ages 18 to 59. There are currently 4 ambulatory clients residing at the home.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: Facility continues to clean and disinfect daily. They are using appropriate hand hygiene and using PPE supplies when necessary. The facility has submitted an Infection Control Plan.

Physical Plant & Environment Safety: There are no swimming pool on the premises or items obstructing the walkways. There are 3 client bedrooms, 1 staff room, 2 bathrooms, living room, kitchen, and attached garage. The outdoor area consists of shaded area for clients to use. The fireplace is not in use and is secured by a fence. Smoke alarms and carbon monoxide detector are operable. Fire extinguisher was last inspected on 5/24/23. Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients. There are no firearms or weapons stored at the facility. Hot water temperature was measured in the bathroom sink and is within the required range of 105 – 120 degrees F.

Operational Requirements: The fire clearance is approved for (6) ambulatory clients and facility is operating within their requirements.

Staffing : There is sufficient staffing at the facility. Staff employed are over the ages of 18 and are fingerprint cleared and associated to the facility.

Personnel Records-Training : Staff files are maintained at the facility. LPA reviewed 2 staff files and they have the required documents such as current First Aid/CPR certification and Health Screening with Tuberculosis test results.