Facility Evaluation Report

Licensing Program Analyst (LPA) Christian Gutierrez conducted an unannounced required annual inspection using the CARE tools. LPA met with Ellisset Ramirez Director and explained the reason for the visit.

This facility is licensed to serve a capacity of fifty (50) Developmentally Disabled Ambulatory Adults, of which ten (10) may be non-Ambulatory. Empower Unlimited Potential is a single-story structure, two buildings consisting of: a kitchen, office, four (4) activity rooms, one (1) client rest room, two (2) beds, three (3) restrooms, reception, and common area, living room area. The Back Building consist of two (2) offices, one (1) classroom, and one (1) bathroom there is also a parking lot behind the main building.

LPA Gutierrez conducted a tour of the facility, reviewed records, and interviewed 3 staff and 3 clients. The following were observed: A total of 38 clients were at the facility during today’s visit with some being out in community. The program site is clean, safe, and in good repair. Disinfectants, cleaning solutions are inaccessible to clients and are locked away. Client’s lunch and snacks are stored in the facility refrigerator. Four (4) bathrooms were observed in good repair, water temperature was tested and not within the required 105–120-degree. Bathroom #1 (B1) 133.7, (B2) 140.7, (B3) 136.3, and (B4) 130.8 deficiency cited. Facility has a fire alarm system with a carbon monoxide detector throughout the facility. Auditory devices on exit doors not working deficiency cited. All rooms were observed to be clean and clear of obstructions. Outside shaded patio area was observed and no potential risks were observed.