Facility Evaluation Report

Licensing Program Analyst (LPA) David España conducted an unannounced Annual required visit with a primary focus on infection control measures. LPA España was met by Mrs. Jacqueline Spencer; Administrator and the purpose of today’s visit was explained. The facility Withers Adult Residential Facility is licensed to serve 8 developmentally disabled clients (age 18-64; 1-17; 65+)

There are currently 4 clients from South Central Regional Center in placement. All (4) clients are ambulatory. The facility is a single-story structure located in a residential neighborhood. It consists of the following: 5 bedrooms, 3 bathrooms (Denote: restroom #1 is considered for staff per Mrs. Jacqueline Spencer), family room/dining room, kitchen, living room, with no shaded area, indoor and outdoor activity area, laundry room and an attached garage.

LPA España and staff (Mrs. Jacqueline Spencer) toured the physical plant. There are no bodies of water or firearm/ammunition on the premises. All client rooms were checked. Beds (total of ten beds at the facility) and bedding were in good condition, adequate lighting provided, storage for client personal belongings was observed. Walls and floors were in good repair. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured restroom #3 at 119.1 F; restroom #2 at 120.0 F; and restroom #1 at 117.F (i.e., staff restroom is numbered 1).

A comfortable temperature is maintained in the facility. LPA España observed the facility to be clean and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning agents, toxins, and sharps were inaccessible to clients. The kitchen was inspected and there is an enough perishable and non-perishable food available which is stored properly. Fire extinguishers (total of three fire extinguishers: 2 located in kitchen, and 1 located by room number 5) were charged, 10 smoke detectors (in each bedroom) and 2 Carbon Monoxide (in hallways) were operable.