Facility Evaluation Report

On 03/22/204 at 8:00 am Licensing Program Analyst (LPA) David España conducted an unannounced Required-1-year annual visit. Upon arrival at the facility, LPA España conducted a risk assessment at the front door. Based on the assessment, the facility is clear of Covid-19 infection (No COVID-19 cases). LPA verified that the facility has an approved mitigation plan report. LPA was granted access and allowed to enter the facility to conduct the inspection. On today's visit LPA met with facility Program Manager Vince Ivory.

LPA España confirmed the census of Sixteen (16). LPA España confirmed there are Ten (10) non-verbal client who only communicate through pictures. LPA España confirmed there are Four (4) verbal client. LPA España confirmed there are Four (4) non-verbal client who do not speak. LPA España interviewed Four (4) staff members. The Adult Day Programs (ADP) facility is licensed for a capacity of Fifty-Two (52) clients (Eight (8) non-ambulatory and 44 ambulatories). The program manager stated that the program has Sixteen (16) clients enrolled in the program. LPA España confirmed present during visit Fifteen (15) clients. The staff to client ratio is One (1) staff to Four (4) clients. Program Manager stated that the program has 0 clients with a Restricted Health Care condition. Continued on LIC809C