Facility Evaluation Report

Licensing Program Analyst (LPA) Jose Villalobos conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA met with House Manager Loida Samonte and the purpose of the visit was discussed. The following (10) of (12) (CARE) tool domains were utilized during the inspection:

Infection control practices and Personal Protective Equipment (PPEs) were observed. COVID-19 screening is no longer in place. The facility has an Infection Control Plan.

A current Plan of Operation was reviewed. The Infection Control Plan has been added to the Plan.

A fire clearance for four clients of which (0) may be non ambulatory; 0 may be bedridden.

The facility is a single story home located in a residential area and contains the following: dining room, kitchen with refrigerator, oven, stove, dishwasher, sink/faucet, locked storage cabinet for sharps, (4) client rooms, (2) bathrooms with shower, toilet and washbasin, and space for washer and dryer. Backyard also has a shaded area and seating for client use. There is an attached garage kept inaccessible to clients. The residence is equipped with central air and heating.

The physical plant was inspected. Exit doors are free of any obstruction and there are no pools or large bodies of water. Cleaning supplies and toxic substances are inaccessible to residents.

Fire Alarms were inspected. Fire extinguishers Observed

Water temperature readings measured within the requi red 105 - 120 degrees Fahrenheit.