Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Wong conducted an annual required visit. LPA met with Administrator Tamaru Francis and explained the reason for the visit. LPA used the infection control tool to evaluate the facility. LPA observed the facility plant, COVID-19 procedures, reviewed clients' medications, observed food supply, and reviewed clients' and staff files. Facility has submitted a mitigation plan and was approved 4/25/2021.

The facility is a single story house and located in a residential neighborhood area. The facility consists of kitchen, dining area, living room, three clients bedrooms, two clients bathrooms, office/supply room and a detached garage. All clients bedrooms were toured. It included two beds, two dressers, required furniture and linen, sufficient lighting and closet space. The two clients bathrooms also toured and they are clean and sanitary and working condition. The hot water was measured between two bathrooms are 113.2 and 114.2 degrees F. The refrigerator and kitchen cabinet in the kitchen and three freezers in the garage have sufficient food supply for two days perishable and seven days non-perishable. The sharp knives and utensils are locked in the kitchen cabinet next to the refrigerator. All the appliances in the kitchen are clean and working properly. The common area such as living room and dining area are clean have the required furniture. The front and back yard are maintained well. The exit and passage way are free of obstruction. The back yard has tables and chairs with shaded area for clients to utilize. The smoke detectors and carbon monoxide detectors are interconnected and located in each bedroom and common area and they are all working well.

LPA reviewed 6 clients' files to confirm emergency contact is updated. LPA also reviewed two staff files to confirm health screenings and fingerprint clearances and they are all fingerprint cleared and their health screenings are updated on the staff files. LPA reviewed all 6 clients' medications and they all seemed accurate and updated.