Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Wong conducted an unannounced annual required visit. LPA met with the administrator, Cynthia Tuason and explained the reason of the visit. LPA used the infection control tool to evaluate the facility. LPA observed the facility plant, COVID-19 procedures and observed food supply. Facility has submitted a mitigation plan and was approved on 05/15/21.

The facility is a single story house located in residential neighborhood. The facility consists of four clients bedrooms, two bathrooms, staff break room, kitchen, living room, dining area, patio and a detached garage. Bedroom#1 and #3 has one bed, one chair, closet, one night stand and an adequate lighting, Bedroom#2 and #4 has two beds, two chairs, two dresser , closet and an adequate lighting. Each client's bed has sufficient linen supply including mattress pads. The hot water temperature in the bathroom and kitchen was measured at 119.6 degrees F. The food supply both perishable and non-perishable is sufficient. The common areas such as living room and dining room are clean and have the required furniture. The back yard has a shaded area and sitting area. The passageways, front, back and side areas are free from obstruction or free of hazards. The smoke detectors and carbon monoxide detectors are inter-connected and they are operational.

Facility is currently following COVID 19 recommendations regarding COVID 19 signs throughout the facility, social distancing by reminding client to be 6 feet apart while sitting on the sofa, disinfecting products are available in each room and facility is disinfected at least two times a day, restrooms have sufficient soap, paper towels, and signs. PPE supplies are sufficient for more than 30 days.

Exit Interview conducted. The copy of the report was provided to administrator Cynthia Tuason