Facility Evaluation Report

Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year visit focusing on COVID-19 Infection Control Practices. LPA met with DSP staff and explained the purpose of the visit. Administrator Zuleyma Osorio and Program Supervisor Darlene Williams arrived shortly after. There are four (4) level 4N ambulatory developmentally disabled clients ages 18-59 in the home. The facility is a single story home located in a residential neighborhood that is licensed for 4 non-ambulatory of which 1 may be bedridden. It consists of 4 client bedrooms, living room/dining room, family room, kitchen, 2 bathrooms, backyard patio area, and a detached garage. The last fire drill was conducted on 9/8/2021.

The interior and exterior physical plant was inspected.

COVID-19 Infection Control Practices and signs were observed in the entrance, common areas, hallways, bathrooms and resident rooms.

Signs are posted throughout the facility to promote hand washing, cough/sneeze etiquette, and physical distancing. Furniture was observed to be at least 6 feet apart.

Each client's room is designated as a COVID-19 solation room if needed.

Four (4) centrally stored resident medication records were reviewed.

Due to client's disability and behaviors none of the clients in care wear masks.

Sufficient supply of perishable for 2 days & non-perishable foods for 7 days were observed.

A posted Emergency Disaster Plan was observed.

Sufficient supply of Personal Protective Equipment (PPEs) was observed.

Staff and resident files were not reviewed during today's visit.

Staff (S1 & S2) do not have a Criminal Background Clearance Transfer Request.

The side yard by the garage had discarded furniture, mirror, and doors.

Exit interview was conducted with Administrator Zuleyma Osorio and Program Supervisor Darlene Williams. A copy of the report was provided.