Facility Evaluation Report

Licensing Program Analyst(s) (LPA) Mary Flores conducted a case management visit during a complaint investigation visit for deficiencies observed. LPA Flores met with Aidee Gutierrez and explained the reason for the visit.

LPA Flores conducted a health and safety check that consisted of the following: LPA tour 4 client bedrooms, kitchen, living room, 3 client bathrooms, and backyard. LPA observed the following: Client's bedrooms have the required bedding and furniture. Bedroom #3 has electrical output case broken, and a floor tile about 2 feet long is loose at the entrance of the room. LPA tested water temperature as follow bathroom #1 tested at 117.1 degrees F, bathroom #2 tested at 113.7 degrees F, bathroom's toilet was observed without a lid, bathroom #3 116.5 degrees F which is within the required 105 to 120 degrees F. Facility has sufficient food 2 days of perishables and 7 days of non perishables. Knives and cleaning supplies were observed locked on a cabinet above washer and dryer area. Fire sprinkle system was observed. Medication was observed in office and under lock. Fire extinguisher observed and current.

Deficiencies will be cited on 809D per Title 22 regulations. Exit interview was conducted with Aidee Gutierrez direct support staff and a copy of this report, 809D, and appeal rights was provided.