Facility Evaluation Report

On 11/28/23 at 10:30AM, Licensing Program Analyst (LPA) Christopher Alemoh conducted an unannounced Required – 1 Year Inspection at GOLTZ ADULT HOME and met with staff (S2) Flosie Tumaliuan LPA explained the purpose of the visit and were accompanied by S2 inside and outside the facility during this inspection.

At 11:00 AM LPA conducted a plant tour. Facility temp measured at 71 degrees. The facility consists of 3 client bedrooms, 1 staff bedroom, 1 bathroom, a living room, dining room, laundry room and kitchen.

This facility is licensed to serve 6 adults ages 18 – 59 years. A total of 2 clients are currently residing in this facility, 2 out of 2 clients are ambulatory. A total of two staff and one client were present during this inspection. Bedroom #3 is designated for non-ambulatory residents.

Outside grounds were toured. The swimming pool was appropriately fenced, no water and it's not being used. Patio furniture under a shaded area was accessible to clients. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises.

3 out of 3 client’s bedrooms were checked. Mattresses were in good condition, adequate lighting, plenty of dresser and closet space observed. Walls and floors were clean and in good condition. Comforters, bed linen, bath towels and mattress protectors were adequately stocked. Bathroom toilets and water faucets worked properly. Adequate lighting and toiletries accessible to clients. LPA Alemoh tested hot water temperature in the middle hallway client restroom, and it measured between 117- and 118.1 degrees Fahrenheit. This facility provides clients with residents with hygiene products such as feminine napkins, non medicated soap, toilet paper, toothbrush, toothpaste, and comb.

LPA observed supplies of nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. Located in the rear pantry next to the refrigerator.