Facility Evaluation Report

Licensing Program Analyst (LPA) Tao conducted an unannounced annual inspection visit. Upon arrival, LPA met Lilian Salmorin, staff, who assist with the 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 staff regarding the purpose of today's visit and the inspection.

During the visit, the Care tool was used, a tour of the facility was conducted, food supply was reviewed, staff/clients files were reviewed and medications were reviewed.

The facility is a single family home located in a residential neighborhood. Facility consists of three (3) bedrooms, staff room, office, two (2) bathrooms, living room, dining room, kitchen, laundry area, 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 provided. 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 117.7 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 3/20/23. Medications are centrally stored, locked and the records are current. Hazardous items are locked and inaccessible to clients. Annual licensing fees are current. Administrator certificate is current with expiration date on 3/2/24.