Facility Evaluation Report

On 07/08/2022 at 01:00 PM, Licensing Program Analyst (LPA) Jose Calderon conducted an unannounced annual inspection visit at the Hayes Home Facility. LPA Calderon was allowed entry into the facility by Administrator Theresa Guzman. The facility is licensed for six residents age 18 to 59 and over of which (3) ambulatory residents. Currently, there are (3) residents residing in the facility, between the age of 18 to 59.

LPA Calderon explained to Administrator Theresa Guzman, the purpose of the 1-year Annual Inspection visit, and escorted LPA Calderon on a tour of the entire inside and outside facility grounds. As part of the inspection, LPA Calderon reviewed: (3) resident service records, (3) resident medication records, and inspected the inside facility and outside grounds. The facilities’ last fire drill was conducted on 11/15/2021. The one-story residential home consists of (2) resident bedrooms, (1) resident bathrooms, living room, dining room, kitchen, staff room, office area, attached garage with washer and dryer/ storage area, backyard with table and chairs. No weapons are stored in the premises. Kitchen was inspected and observed to be clean and operational. A 2-day supply perishable and 7-day supply of non-perishable foods are present in the facility. Emergency Water Storage is in the garage.