Facility Evaluation Report

On 03/25/24, 9:00AM Licensing Program Analysts (LPAs) Raymond Comer and Gina Saucedo conducted an unannounced Annual Required visit to this facility. LPA'S met with caregiver, Rodel Mayuga. Mr. Mayuga informed LPAs that the Administrator was currently not at the Facility and called designee co-Administrator, Meg Itchon, who showed up twenty minutes (20) later, and the purpose of visit was stated. The facility is licensed as a single-story residence, 4 Ambulatory, Age range 1 through 59, Developmentally Disabled. Facility has three (3) residents bedrooms: Two (2) private rooms and one (1) shared room. Facility has two (2) bathrooms. An additional bedroom is designated for staff use. There is no bodies of water in the facility.

At 9:40AM, LPAs conducted a tour of the physical plant with the co-administrator and observed the following:

Physical plant was inspected for cleanliness and condition. Facility’s main door is the primary entry/exit access. Side door is located west of the house, exiting to back yard. Screening area is located immediately upon entrance. Door signage displays, “Everyone entering facility must wear mask and must be screened.” Visitor Sign-in sheet, hand sanitizer, gloves and masks are available. Signage to wear a mask, and other Covid 19 prevention protocols are posted. Hand washing, coughing etiquette, physical distancing and other necessary signage were posted in the bathroom and throughout the facility. All trash cans were observed to be with cover. The facility has submitted and approved Mitigation and Infection plan. Required postings are prominently displayed and observed to be current at the facility.

Fire Detection/Protection systems are present at facility. Multiple smoke alarms are installed, hardwired and interconnected. Carbon monoxide detector alarm is installed and tested. Fire extinguisher is located in Kitchen area; displayed as fully charged, with inspection service date/purchase date: 02/22/2024. Disaster drills were last conducted on 3/1/2024.