Facility Evaluation Report

On 06/18/2024 10:50 a.m. Licensing Program Analyst (LPA) Evelin Rios arrived at the facility listed above to conduct an unannounced required annual inspection. LPA was greeted by staff #1(S1) Delfin Leonida and granted access. S1 informed LPA they would call the Administrator, Teresita Astudillo. Teresita informed LPA she is not in the area but will try to meet LPA. At this time administrator will be available by telephone. LPA explained the reason for the visit. Entrance Interview conducted.

The facility has four (4) bedrooms and two (2) bathrooms. One (1) bedroom is designated for live-in staff and has a private bathroom for staff use only. The facility has Fire Clearance for six (6) ambulatory clients.

A tour of the physical plant was conducted with S1 at approximately 11:00 a.m. and the following was observed:

Kitchen: LPA conducted a tour of the kitchen at approximately 11:00 a.m. and observed there to be sufficient supply of two-day perishables and seven-day non-perishable foods, properly stored. Food storage and preparation areas were clear of clutter. LPA observed inside the kitchen cabinets and drawers to have grease build up and food crumbs. LPA also observed cobwebs with a live spider on top of the fridge. LPA observed all knives, sharp object, locked in kitchen cabinet inaccessible to clients in care.

Living and dining areas: LPA observed the living area clear of clutter. The furniture sits the capacity of the facility. LPA observed a window by the living room missing a window boarded up with cardboard. At 11:10 a.m. LPA observed S1 test a smoke detector. Detectors do not appear interconnected. S1 was only able to test one (1) out of the four (4) observed in the facility. Smoke detector tested in the hallway was operational. Carbon monoxide detector was observed to be functioning properly. LPA observed one (1) fire extinguisher located by the kitchen, fully charged. (Continued to LIC809-C)