Facility Evaluation Report

Licensing Program Analyst (LPA) Daniel Konishi conducted an unannounced annual visit at the facility using the CARE Tool. LPA met with the Direct Support Professional (DSP), Amelita De Gala and explained the purpose of the visit. Assistant Administrator, Rhona Amado arrived shortly after to assist with the visit and the LPA explained the purpose of the visit. The facility is licensed to serve four (4) ambulatory only developmentally disabled clients ages 18-59 years old. Facility is operating within the scope of its license.

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

1. Infection Control: The facility has an Infection Control Plan in place and the facility continue to practice infection control with hand washing and disinfecting the facility. The facility has sufficient PPE supplies.

2. Physical Plant and Environmental Safety: A tour of the single-story residential home included the living room, dining area, kitchen, two (2) client bedrooms, one (1) staff room, two (2) bathrooms, an attached garage, front yard, and backyard. Each client's bedroom has two beds, two drawers, a nightstand, the required furniture and bedding and sufficient lighting and close space. The clients’ bathrooms are in good working condition. However, LPA and Staff #1 (S1) observed small bugs crawling in the bathroom cabinet and wall. Extra bed linens, sheets, pillowcases, and towels are located in the hallway cabinet. The hot water temperature in both bathrooms were tested between 105.0- and 105.1-degrees F which is within the Title 22 regulation. All the kitchen appliances are working properly. All the sharps are locked in the medication cabinet. All the chemical and cleaning supplies are stored and locked underneath the kitchen sink.