Facility Evaluation Report

On 9/9/2021, Licensing Program Analyst (LPA) Stephanie Cifuentes conducted an unannounced annual required visit with a primary focus on Infection Control measures using the new CARE Inspection Tool. LPA met with staff Tracey Jewells explained the purpose of today’s visit. The facility is licensed for four (4) ambulatory clients between the ages of 18-59.

The facility is a two-story home located in a residential neighborhood. The facility consists of the following: four (4) resident bedrooms, office, two (2) bathrooms, dining area, kitchen, living room and shaded patio area in the backyard.

LPA and staff toured the physical plant. There were no obstructions on the premises or small bodies of water. Beds and bedding supplies were in good condition, adequate lighting provided, storage for client personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational.

LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Cleaning supplies, toxins, and sharps objects were stored and not accessible to clients. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. Seven (7) smoke detectors were observed to be hardwired and interconnected. Facility has three fire extinguishers, fully charged.

During the visit, LPA observed the facility infection control practices. LPA reviewed screening protocol for visitors, staff, and residents, sanitizing stations in common areas and restrooms. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted and available.

No deficiencies were cited during this inspection visit.

Advisory Notes - Technical Assistance was issued, please see LIC9102-AN.

An exit interview was conducted and a copy of this report was provided to Tracey Jewells.