Facility Evaluation Report

Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted a Required One (1) year annual visit and inspection. LPA met with Lead Direct Support Professional (DSP) who called the Administrator and purpose of the visit was stated. Later, Administrator joined the today’s visit. The facility is fire cleared for four (04) ambulatory clients.

At 10:00a.m., DSP and LPA conducted physical plant tour inside and out. During the tour, LPA observed that the facility has (04) bedrooms and three (03) bathrooms. Two (02) private bedrooms, one (01) shared bedroom and one (01) bedroom converted into a staff office. Fire/Earthquake drill was last conducted on 11/13/2024. Required posting observed in facility (complaint hot line poster, personal rights, etc).

The front main door is the only entrance being utilized at the facility. Sign in sheet and hand sanitizer area is located immediately before entrance. The facility had submitted and approved Mitigation and Infection Plan. Hand washing signs were posted in the bathrooms. All trash cans were observed to be with cover.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Bedrooms were toured and observed to be clean and properly furnished with appropriate dresser, beddings, and linens with sufficient lighting. Linen storage was also checked and observed to have ample supply of clean linen, comforts and towels in the hallway closet. Office designated for staff use maintains staff folder and office supplies.

Bathrooms were observed to be clean, sanitary and with necessary supplies. The appropriate grab bars and mats in the shower. Hot water temperature measured at a range of 112.7°F to 113.5°F and within the required range. Client’s personal hygiene supplied are kept in their personal space. Towels and washcloths are not shared.