Facility Evaluation Report

Licensing Program Analyst (LPA) V. Maldonado made an unannounced visit to the facility for the purpose of conducting the required annual inspection, using the Infection Control tool to evaluate the facility. LPA Maldonado met with staff Kim Salvador and explained the purpose for the visit. LPA conducted a tour of the physical plant with staff, observed the food supplies, COVID-19 procedures, and reviewed client and staff files, and client's medications. The facility has an approved mitigation plan on file. Assistant Administrator Loida Samonte arrived shortly after to assist with the visit.

The facility is a one-story home located in a residential area. It is licensed to serve (6) developmentally disabled clients, ages 18-59, all ambulatory only. The home consists of a living room, kitchen, dining room, den (3) client bedrooms, (2) staff bedroom, (2) bathrooms, a shaded patio in the backyard with seating, and an attached garage. LPA observed all client bedrooms to have the required furniture, bedding, linens, sufficient lighting, closet space, and additional storage space. (2) bathrooms were observed to have a shower, toilet, and wash basin. During the inspection of the bathrooms, LPA observed 2 cockroaches come out of a bathroom drawer when it was opened and several small dead cockroaches in the drawer. Staff stated they were unaware of any recent issues with cockroaches. The water temperature was tested and measured between 120*F-123*F, which is not in compliance. The food supplies was observed to be the required 2-day perishables and 7-day non-perishables. Fire extinguishers were observed in the kitchen, den, and laundry space in the hallway, to have current inspections and were fully charged. The first aid kit was inspected and was missing required items such as scissors and tweezers. A current first aid manual was observed. All sharps were observed to be locked and inaccessible in a drawer in the kitchen, across from the sink. Cleaning supplies were locked and inaccessible, stored in a cabinet underneath the kitchen sink and in a supply cupboard in the garage. All equipment was operational and in good repair. A hallway closet had additional towels and linens for clients- inspected and in good repair. The smoke/carbon monoxide detectors were tested, were interconnected and operational at the time of the visit. (Report continued on LIC809-C...)