Facility Evaluation Report

On 10/25/2023 at 09:00 AM, 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 aged 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 one-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: three (3) resident service records, three (3) resident medication records, two (2) staff records. LPA Calderon interviewed three (3) residents and two (2) staff members for visit and inspected the inside facility and outside grounds. The facilities’ last fire drill was conducted on 07/01/2023 . The one-story residential home consists of four (4) resident bedrooms, two (2) resident bathrooms, living room, dining room, family room, kitchen, 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 two-day (2) supply perishable and seven-day (7) supply of non-perishable foods are present in the facility. Emergency Water supply is found in the garage.