Facility Evaluation Report

Licensing Program Analyst (LPA) Daniel Konishi conducted an unannounced annual using the CARE inspection tool. LPA met with DSP, Katherine Paez and LPA explained the reason for the visit. Administrator Cristina Caballes arrived shortly and LPA explained the purpose of the visit. Facility is licensed to serve one (1) ambulatory and three (3) non-ambulatory clients between the ages of 18 to 59 years old.

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

Infection Control: Facility maintains an infection control plan. Hand sanitizing and infection prevention were observed at the facility. A responsible person was available at the facility.

Physical Plant & Environmental Safety: Facility is a single-story home located in a residential neighborhood and consists of four (4) client bedrooms, office, living room, a kitchen, two (2) bathrooms, a front yard area, a back patio area and a detached garage. LPA toured the facility and observed that the facility is clean and in good repair indoors and outdoors. Living room, dining room have sufficient seating area. Each client bedroom has sufficient lighting, the required furniture and bedding supplies. Two (2) bathrooms were observed clean and in good repair. Water temperature was tested between 111.0 degrees F to 113.1 degrees F, which is within the required 105-120 degrees F. LPA observed extra linens and towels are in the closet near the hallway. LPA observed no large bodies of water. Carbon Monoxide/Smoke detectors were observed. Laundry area was observed clean and in good repair. Sharps are locked and inaccessible to clients. LPA observed the fireplace being closed and inaccessible to clients. Cleaning supplies and toxins are locked and inaccessible to clients. Kitchen was observed clean, in good repair. [Continue to LIC809-C]