Facility Evaluation Report

Licensing Program Analyst (LPA) Jose Villalobos conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA met with House Manager Nick Baez and the purpose of the visit was discussed. The following (CARE) tool domains were utilized during todays inspection:

A current Plan of Operation was reviewed.

Facility operating within the fire clearance of (6) Clients of which 2 can be non ambulatory .

The facility is located in a residential area. The facility has 4 bedrooms, 2 bathrooms, living room, dining area, kitchen, and attached garage

The physical plant was inspected. Exit doors are free of any obstruction and there are no pools or large bodies of water. Cleaning supplies and toxic substances are inaccessible to clients

Fire Alarms were inspected. Fire extinguishers Observed

Water temperature readings measured within the required 105 - 120 degrees Fahrenheit.

Internet source provided to clients in care. Required postings observed.

Sufficient food supply is stored in the kitchen and pantry areas consisting of: 2-day perishables, 7-day non-perishables, and emergency food supplies observed.

Sanitation practices and kitchen cleanliness was observed.

LPA to continue Inspection at a later date as (8) of (12) domains are still needed. No deficiencies are being cited. Exit Interview Conducted and a copy of this report was provided.