Facility Evaluation Report

Licensing Program Analyst (LPA) Gary Tan met with Administrator Florida Malla for a One (1) Year Required visit for this facility. LPA explained the reason for the visit.

A tour of the physical plant was conducted at 2:48 PM and the following was noted:

There is only one entrance being utilized at the facility, there are required poster posted at the main door. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available. The facility had submitted and approved Infection Control and Mitigation plan.

Signs to wear a mask and other Covid 19 prevention protocol signs were posted outside and inside. Hand washing, coughing etiquette, physical distancing and other necessary signs were posted in the bathroom and all over the facility. The facility has a designated visitors' area at the backyard. The facility has sufficient stock of PPE in the storage room.

The facility has four (4) bedrooms and two (2) bathrooms currently occupying two (2) residents. One (1) bedroom and one (1) bathroom is designated for staff use. The facility is fire cleared for six (6) ambulatory residents.

Living and dining room furniture were also checked. The living room is neat and clean. The facility maintains a comfortable temperature at 75°F. The smoke detectors are battery operated and observed to be operational. There is a carbon monoxide installed at the facility. Fire extinguisher is located in the kitchen and last bought on 11/08/23. The backyard of the facility has shaded area with outdoor furniture, with a covered shaded area for clients. There is no body of water in the facility. (continued on LIC 809-C)