Facility Evaluation Report

On 09/30/2024 at 12:20 p.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) who granted access. LPA explained the reason for the visit. S1 contacted the administrator. This is an Adult Residential Facility (ARF) Level 4i. The facility has an approved Fire Clearance for four (4) ambulatory clients. The administrator, Daniel Morales arrived shortly after.

A tour of the physical plant was initiated by the LPA at approximately 12:30 p.m., and the following was observed:

Kitchen: LPA conducted a tour of the kitchen and observed there to be sufficient supply of two-day perishables and seven-day non-perishables foods, properly stored. Food storage and preparation areas are clean and clear of clutter. Knives and sharp objects are locked in a cabinet in the laundry room inaccessible to clients in care. LPA observed a fire extinguisher located by the kitchen fully charged. LPA observed the facility telephone accessible to clients on the kitchen counter.

Common Areas: These include the living area, dining area, and multi purpose room. LPA observed these areas to be clean and clear of clutter. The furniture was in good repair and sits the capacity of the facility. In the dining area LPA observed an fire place closed with a screen. Residents’ records, staff records, medication logs, medication and facility files are stored in a locked room located within the multi-purpose room.

Bathrooms: The facility has three (3) bathrooms. LPA observed the bathrooms to be clean and properly supplied with hand soap, toilet paper and paper towels. (Continued on LIC809-C)