Facility Evaluation Report

Licensing Program Analyst (LPA) Sanjay Vaid conducted an unannounced annual inspection. LPA met with caregiver, Lucita Atanacio and discussed the purpose of today's visit, Administrator not available today. The facility is licensed to serve six (6) mentally disable ambulatory only clients, from age 18-59. Facility annual fees were current. Administrator certificate is current and expires on 03/26/2027. Currently serving five (5) clients.

For today's annual visit, CARE tools were applied, physical plant was conducted, staff/clients were interviewed, and food supply/medications/medication records/staff files/clients’ files were reviewed.

Staff are adhering to operational requirements. Smoke alarms and carbon monoxide detector tested and operable. Fire extinguisher is in the kitchen, fully charged. Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients.

There is sufficient staff at the facility. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility.

LPA reviewed staff files for Staff #1 (S-1) through Staff #3 (S-3). Staff have current First Aid/CPR certification. Staff have their Health Screening and Tuberculosis Screening on file. Client rights observed to be posted. LPA reviewed Client files for Client #1 (C-1) through Client #5 (C-5). The following were observed: Admission Agreement, Physician's Report (including T.B and Ambulatory Status), Functional Capabilities Assessment, Consent for Medical Treatment, House Rules, and Client Rights.