Facility Evaluation Report

Licensing Program Analyst (LPA) Christian Gutierrez conducted the annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA met with DSP worker Mardy Lipatan at approximately 10:11 AM and explained the reason for the visit. Acting Administrator Czarina Dorotan arrived shortly.There are currently six (6) clients in the facility. The facility is licensed to serve (6) developmentally disabled adults ages 18-59 years old of which (2) two can be non-ambulatory clients in room #3. Facility is operating within the approved capacity. The home consists of the living room, dining room, kitchen, (3) three client bedrooms, (1) one staff bedroom, office, (2) two bathrooms, detached 2 car garage/storage, and detached utility room/laundry room.

LPA Gutierrez conducted a tour of the facility, reviewed records, and interviewed 1 staff, and 1 client. The following were observed: Two (2) out of three (3) bedrooms have the required furniture such as bed frames, dressers, lamps, and chairs. Bedroom #1 is missing two chairs and two night stands deficiency was cited. Bedrooms #1 also had hole from clients punching it on side of bed. Client beds have the required linen. Each bedroom has a smoke detector which were tested. There is a carbon monoxide detector located in the hallway and another in the living room area. The bathrooms were observed to be clean. The hot water was between 106.7 to 110.3 degrees which is within the required 105 - 120 degrees. There is a fire extinguisher in the living room and is fully charged. Sharps are locked in the kitchen and inaccessible to residents. Cleaning supplies and toxins are locked in outside cabinet and inaccessible to residents. First Aid kits were fully stocked with current manuals. There was a sufficient supply of 2 days perishable foods which included fruits and vegetables. Seven (7) days non-perishable foods were observed. The front and backyard are well maintained and there are no pools or large bodies of water Passageways and exits are free of obstruction. Backyard has a front and back patio area laundry machine, an office, a staff kitchen, and a detached garage which is a storage area for the facility.