Facility Evaluation Report

Licensing Program Analyst (LPA) Kruz Long conducted a site visit for the annual inspection. Upon arriving at the facility LPA met with Nina Ricci Chua (Direct Support Staff) and explained the purpose of the visit. The facility is licensed to serve FOUR (4) DEVELOPMENTALLY DISABLED ADULTS, TWO (2) AMBULATORY AND TWO NON-AMBULATORY WITH RESTRICTED HEALTH CONDITIONS.

The facility is located in a residential area. A tour of the single-story facility includes: Living room, kitchen, dining area, 4 client bedrooms, 2 bathrooms and attached garage/storage.

During today’s visit, LPA observed the following: Licensee is not operating beyond the conditions and limitations specified on the license, including the capacity. All clients are protected against hazards. All outdoor and indoor passageways are free of obstruction. There are no pools or large bodies of water on the premises. There are no firearms on the premises and other dangerous weapons such as knives are locked in the kitchen cabinet. Disinfectants, cleaning solutions, poisons are inaccessible to clients. A comfortable temperature for clients is maintained. Lamps or lights in all rooms to ensure the comfort and safety were observed. Hot water temperature measured at 112.9 degrees F in bathroom #1. All toilets, hand washing and bathing facilities is safe, sanitary and in operating condition. Hygiene products such are readily available. Smoke detectors and carbon monoxide detectors are operational. Fire extinguisher in the kitchen is fully charged. Outdoor shaded area observed. All foods are selected, stored, prepared and served in a safe and healthful manner. Nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days were observed. Freezers and refrigerators are clean, and maintain temperatures. Sufficient staff as necessary to ensure provision of care and supervision was observed. Staff have a criminal record clearance and current first aid. LPA was allowed to enter the facility to conduct the inspection. The administrator is on the premises a sufficient number of hours necessary to adequately administer the facility All medications are labeled and maintained in compliance. Medications are safe, locked and centrally stored.

No deficiencies were observed during today's visit.

An exit interview was conducted and a copy of this report was provided to Nina Ricci Chua.