Facility Evaluation Report

Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced required annual visit with a primary focus on Infection Control measures using the CARE Inspection Tools. LPA met with Administrator in training, Ruth Gonzales, and the purpose of this visit was explained. The facility is licensed for 4 non-ambulatory clients; and there are currently four (4) residents in placement.

The facility is a single story home in a residential neighborhood with a driveway. The facility consists of a living room, family room, dining room, kitchen, six (6) bedrooms, two (2) full bathrooms, laundry room, activity room and an attached garage.

LPA walked through all six (6) rooms. Bedrooms 1-4 are designated for the resident’s individual use. All bedrooms contained a bed, dresser, nightstand, chair, ample lighting and closet space. Room 5 is the designated activity room and Room 6 is designated as an office.

LPA walked through the kitchen and all appliances were in good working order. Knives were locked and stored in a drawer in the kitchen and inaccessible to residents. LPA observed a 3-day supply of perishable and a 7-day supply of nonperishable foods. The water temperature measured 115.4 degrees Fahrenheit.

All bathrooms were checked, sufficient liquid soap and paper towels were observed. Toilets and water faucets worked properly. The walk-in shower was free of mildew and mold and had shower chairs available. LPA walked through the laundry room, all cleaning products were locked in a cabinet and inaccessible to residents.

LPA walked through all common areas. In the living room, family room, dining room and activity room there is ample seating and space for all residents. LPA observed games and activities for residents. All rooms and walkways were clean, and clear of obstructions and hazards. All areas have ample lighting. All rooms, hallway, family room and living room have working smoke detectors. Carbon monoxide detector was functional. There is a fully charged fire extinguisher in the dining room.