Facility Evaluation Report

Licensing Program Analyst (LPA) Ashley Calderon conducted the unannounced Annual Inspection and met with DSP Vena Myles and DSP Quindelyn Brown who allowed the entry of the facility. Shortly after, LPA met with Supervisor Gilbert Cardenas and explained the reason of today's visit.

For today's inspection LPA used the Compliance And Regulatory Enforcement (CARE) Tools to inspect the facility. The facility is licensed for age range 18 through 59 and 4 ambulatory of which 2 may be non-ambulatory. The facility has (4) bedrooms and (2) bathrooms, backyard and an detached garage.

The following was observed, reviewed and inspected:

LPA reviewed all (4) clients files and reviewed Administrator's and (3) DSP staff files. Staff were cleared, CPR/First Aid certified and had all documentation's in place. Residents had appropriate documentation's, P&I Ledgers and Physician Report w/ TB.

LPA reviewed (4) client medications and Medication Administration Record, all medications had labels, in place and no deficiencies were observed.

LPA and Supervisor toured/inspected the physical plant: all bedrooms are designated for clients as private bedrooms, no staff bedroom, all bedrooms contain the required about of furniture and lighting fixtures, mattresses and box springs are in good repair, beds have the required amount of linen. (2) bathrooms were clean and operational. Hallway is free of obstructions, common areas are organized and appropriately furnished, telephone and internet in place for residents use. (Continuation 809-C...)