Facility Evaluation Report

Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted an unannounced Required One (1) year inspection to the facility. LPA met with Direct Support Professional (DSP) and granted entry to the facility. At 10:00a.m. DSP called Administrator and indicated that will not be able to join todays visit. Administrator authorized Assistant Administrator to sign the report and the purpose of this visit was explained. Later, Assistant Administrator joined the visit.

At 10:15a.m., DSP and LPA conducted physical plant tour inside and out. During the tour, LPA observed that the facility has five(05) private bedrooms and three (03) bathrooms. Fire drill was last conducted on 11/13/2024. Required posting observed in facility (complaint hot line poster, personal rights, etc).

The front main door is the only entrance being utilized at the facility. The facility had submitted and approved Mitigation and Infection Plan. Hand washing signs were posted in the bathrooms. All trash cans were observed to be with cover.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Bedrooms were toured and observed to be clean and properly furnished with appropriate dresser, beddings, and linens with sufficient lighting. Linen storage was also checked and observed to have ample supply of clean linen.

Bathrooms were observed to be clean, sanitary and with necessary supplies. The appropriate grab bars and mats in the shower. Hot water temperature measured at a range of 113.7°F to 115.5°F and within the required range. Client’s personal hygiene supplied are kept in their personal space. Towels and washcloths are not shared.