Facility Evaluation Report

Licensing Program Analysts (LPAs) Jose Villalobos conducted the unannounced Annual Inspection visit using the Compliance And Regulatory Enforcement (CARE) Tool. LPA met with Staff Gertrudes Armamento and the purpose of the visit was discussed. The following tool domains were completed:

Infection Control: LPA observed the facility has sufficient PPE supplies. Infection Control Plan was collected and reviewed.

Physical Plant and Environmental Safety: The facility is licensed to serve up to (6) developmentally disabled adults ages 18 to 59 years old, of which (4) may be non-ambulatory. There are currently 5 clients at this home of which (2) are non ambulatory. Facility is located in a residential area and consist of (4) client bedrooms, 3 bathrooms, (2) living rooms, kitchen with dining area, covered backyard deck, and a detached garage. The facility was inspected during the physical plant tour. No passageways or paths were obstructed.

Operational Requirements: Facility is operating within its approved clearance. Activities Calendar observed

Staffing: The facility has a sufficient amount of staff per shift in the facility. LPA reviewed staff roster to verify that there is a staff present during the Nightshift.

Personnel Records-Training: Personal records centrally stored. LPA inspected six (6) staff files. All staff are background check cleared and associated with the facility. All the staff files have the required Title 22 documents. The administrators certificate is currently active.

Client's Right - Information: No client in the facility required any postural support at the present time. Required postings observed.