Facility Evaluation Report

Licensing Program Analyst (LPA) Tao, conducted an unannounced annual inspection. The facility is licensed to serve six (6) mentally disabled clients from ages 18-59. Ambulatory only. Client census is four (4). LPA was allowed entry by staff, Florante Viloria. The annual fee is paid. Licensee, Adelina Esgerras, joined the visit via phone call. LPA discussed the purpose of today's visit.

During the visit, the following domain of the new inspection tool was used: infection control domain; a tour of the facility conducted; food supply was reviewed; and medications were reviewed.

The facility is a single story home located in a residential neighborhood. LPA observed the facility to have 3 client bedrooms, a Caregiver room, 2 bathrooms, living room, dining room, kitchen, garage, laundry area on the back porch and an indoor/outdoor activity area. A shaded area with chairs is provided in the rear.

LPA inspected facility common areas including the kitchen, living room, and dining area. Fire extinguisher was fully charged and the last service was on 7/10/21. Comfortable temperature of 73 degree Fahrenheit for clients was maintained. Client bedrooms were checked and closet/drawer space to accommodate each client is available. Lamps/lights for each room are available to ensure the safety and comfort of all persons in the facility. Adequate linen and personal hygiene supply are observed. Bathrooms are operational.