Facility Evaluation Report

Licensing Program Analyst (LPA) Tao conducted an unannounced annual inspection visit. Upon arrival, LPA met with Staff, Joshua Santos, who contacted the Administrator. About 45 minutes after, the Administrator, Priscilla Nanong arrived to assist with visit. The facility is licensed to serve six (6) Developmentally Disabled Adult clients (ages 18-59), Ambulatory only. Currently, there are six (6) clients in placement. LPA discussed with administrator regarding the purpose of today's visit and the inspection.

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

The facility is a single-story house located in a residential neighborhood. LPA toured the facilities physical plant, indoor and outdoor. Facility consists of three (3) bedrooms, a staff room/office, two (2) bathrooms, living room, dining room, kitchen, laundry room, garage and an indoor/outdoor activity area. Client rooms are furnished with appropriate furniture for clients’ comfort. Bathrooms are operational and furnished with grab bars and nonskid surfaces. Common areas are observed for the ability to safely serve the needs of the clients. A shaded area with chairs is provided in the back yard. The yard is free of debris/ hazard, and there are covered trash cans. Sufficient supply of perishable and nonperishable foods is observed.

Smoke detectors and carbon monoxide detector are operable and in compliance. Fire extinguishers are fully charged. The first aid kit is fully stocked. Hot water temperature measured at 110.7 degrees Fahrenheit which is within Title 22 Regulation guidelines. Adequate linen and personal hygiene supplies are observed. The last Fire/ Emergency Drill was conducted on 03/20/22. Medications are centrally stored, locked and the records are current. Hazardous items are locked and inaccessible to clients. Annual licensing fees are current.