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 Administrator Anthony Johnson and the purpose of the visit was discussed. The following (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 for LPA to review.

A current Plan of Operation was reviewed.

A fire clearance for Four (4) clients of which (0) may be non ambulatory;0 may be bedridden.

The facility is a single-story home located in a residential area. A tour of the facility includes: living room, dining area, kitchen, 4 bedrooms, 2 bathrooms (one is a private full bath within the client bedroom), attached garage with laundry and storage, front yard and back yard.

The physical plant was inspected. Facility is clean and in good repair. 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 clients. Fire Alarms were inspected. Fire extinguishers Observed

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

Sufficient staff observed to meet clients needs

Facility currently provides care and supervision for a total of Four (4) Clients.

Internet source provided to clients in care