Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Wong conducted the required annual inspection. LPA arrived unannounced and met with the administrator Sandra Empson who allowed the entry of the facility and assisted with the visit. The purpose for the visit was explained. The facility is LICENSED TO SERVE FOUR DEVELOPMENTALLY DISABLED CLIENTS AGES 18-59. AMBULATORY ONLY.

LPA Wong utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and here are the domains that LPA inspected:

1. Infection Control: The facility staff are using appropriate hand hygiene and wearing gloves while assisting clients. Staff are cleaning and disinfecting at least once a day and more often for high touched surfaces area. Facility has sufficient PPE supplies and has an Infection Control Plan.

2. Physical Plant and Environmental Safety: The facility is a single story house and located in a residential neighborhood area. The facility includes living room, dining area, three clients bedrooms, administrator bedroom with bathroom, client's bathroom, kitchen, den/TV room, a detached garage and laundry room. The passageways, walkways, driveways and patios are free from obstructions. Bedroom#1 and #3 has one bed, one drawer, one night stand, required bedding and sufficient lighting and closet space. Bedroom#2 has two beds, two drawers, required beddings and sufficient lighting and closet space. The bathroom is clean, sanitary and in a workable condition. The hot water temperature tested in the bathroom was 119.6 degrees F which is within the Title 22 regulation. All the appliances in the kitchen are working properly and all the sharp knives and utensils are stored and locked in the kitchen cabinet. The facility has a land line telephone system on the premises. The facility has ample supply of personal hygiene products and stored at the hallway linen closet and the client's bathroom.

3. Operational Requirements: The facility maintained a fire clearance approved by the fire department which they currently have all three ambulatory clients only. The facility also has shaded area with table and chair for client to utilize for outdoor activity. The last fire and disaster drill was conducted on 02/21/23