Facility Evaluation Report

Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit and was greeted by Staff Martha Santana and explained the reason for the visit.

The purpose of the visit is to complete the required inspection.

Shortly thereafter Administrator Henry Lara arrived.

LPA Trueman toured the facility along with Staff Martha Santana today 03/14/2023 at 2:00 PM and the following was observed:

Facility contains 3 Bedrooms and 2 Bathrooms, dining room, living room, and TV room.

Annual Inspection includes the following Domains:

Infection Control, Physical Plant and Environmental Safety, Operational Requirements, Staffing, Personnel Records- Training, Client Rights Information, Client rights- Incident Reports, Food Service, Health Related services, Incidental Medical Services, and Disaster Preparedness.

Beds have the required linen and the linen is in good condition.

There are 2 Client bathrooms. The bathrooms are clean and have the required hygiene items. The hot water temperature was within the required 105 - 120 degrees.

The facility temperature at the time the visit was comfortable.

There is sufficient lighting throughout the facility. There are smoke detectors located throughout the facility. There is a carbon monoxide detector. The kitchen was inspected. There is sufficient perishable and non-perishable food. The food was also stored properly. Kitchen appliances are clean and are operating properly. The front and backyard are well maintained. There is no pool or other large bodies of water.

Planned activities are conducted daily and there is sufficient space inside and outside of facility.

2 Staff were interviewed and 1 Client was interviewed. 3 Clients were out in the community.

4 client files were reviewed and 6 staff files were reviewed.

Exit interview conducted and copy provided.