Facility Evaluation Report

Licensing Program Analyst (LPA) Kruz Long conducted a site visit for the annual inspection. Upon arriving at the facility LPA met with Victor Mora (Administrator) and explained the purpose of the visit. The facility is licensed to serve: AGE RANGE 18 THROUGH 59. FOUR AMBULATORY ONLY.

The facility is located in a residential area. A tour of the single-story facility includes: Living room, kitchen, pantry, dining area, attached garage/office/storage, 4 bedrooms, 1 staff room, 2 and 1/2 bathrooms and laundry room.

During today’s visit, LPA observed the following: Licensee is not operating beyond the conditions and limitations specified on the license, including the capacity. All clients are protected against hazards. All outdoor and indoor passageways are free of obstruction. There are no pools or large bodies of water on the premises. There are no firearms on the premises and other dangerous weapons such as knives are locked in the kitchen drawer. Disinfectants, cleaning solutions, poisons are inaccessible to clients. A comfortable temperature for clients is maintained. Lamps or lights in all rooms to ensure the comfort and safety were observed. Hot water temperature measured at 115.3 degrees F in bathroom #1. All toilets, hand washing and bathing facilities is safe, sanitary and in operating condition. All foods are selected, stored, prepared and served in a safe and healthful manner. Nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days were observed. Freezers and refrigerators are clean, and maintain temperatures. Sufficient staff as necessary to ensure provision of care and supervision to meet client needs were observed. All staff have a criminal record clearance. Each client record contains the Needs and Service Plan and a Mental Health Intake Assessment. Staff responsible for direct care and supervision have current first aid. All medications are labeled and maintained in compliance with label instructions and State and Federal law. Medications are safe, locked and inaccessible.

No deficiencies were observed during today's visit.

An exit interview was conducted and a copy of this report was provided to Victor Mora