Facility Evaluation Report

Licensing Program Analyst (LPA) Luis Mora conducted an announced Pre-Licensing visit. LPA met with Sandra Benson (Licensee) and explained the reason for the visit. A change of ownership application was submitted to Community Care Licensing Department (CCLD) for an Adult Residential Facility to serve 4 ambulatory clients in the age range of 18 through 59.

The facility is in a residential area and it is a one story family home. A tour of the single-story facility included the 4 client bedrooms, 2 bathrooms, living room, kitchen, detached garage, front yard and back yard. LPA Mora conducted the tour with Sandra Benson and observed the following: sufficient food supplies for at least 2 days of perishables and 7 days of non-perishables were observed in the kitchen. Sharps were observed locked under the kitchen sink. Chemical and cleaning solutions are kept locked in a laundry room cabinet. Medications are kept locked in a dining room cabinet. Client and staff files are kept in the medication cabinet. The First Aid kit is kept locked in the medication cabinet and it is fully stocked with all required items including a current manual. Clean towels and extra clean linen were observed in the hallway closet. Dining and living room have sufficient lighting and sitting area. All bedrooms have all required furniture, lighting, and bedding. All showers were observed with non-skid material and bathrooms have non-slip rugs. The water temperature was tested in both bathrooms and measured at 111.7 degrees F and 113.8 degrees F, which is within the required 105-120 degrees F. Fire extinguishers were observed in the kitchen and hallway, and are is fully charged. Smoke detectors were observed throughout the facility and in each room and were operable during the visit. A carbon monoxide was observed in the hallway and was operable during the visit. The front yard and backyard are clean. There is a shaded area with seating in the backyard. No bodies of water were observed at the facility. Passageways and exits are free of obstruction.

Facility has 30 days supplies of Personal Protective Equipment in the garage. Facility is following COVID-19 recommendations regarding screening visitors, staff, and clients. Covid-19 prevention signs are posted throughout the facility and hand-washing signs were observed in the bathrooms. Sufficient hand soap, hand sanitizer, and paper towels were observed.