Facility Evaluation Report

Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted an Required One (1) year annual visit and inspection. LPA met with Caregiver who called the Administrator and purpose of the visit stated. Later Administrator joined us. LPA observed that one (1) resident were at the facility during visit.

At 11:00a.m., with the assistance of Caregiver, LPA took a tour of the physical plant. Required postings were observed in the breakfast nook, family room and dining area. The facility is a single-story house in a residential community with five (5) bedrooms and two (2) bathrooms. Two (2) bedrooms are designated for staff use.

The facility is fire cleared for six (06) non-ambulatory. The facility offers level four (4) care to clients. The last fire drill was conducted on 07/15/2024. Care and supervision to meet the client’s needs was observed. There is no body water in the facility.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Bedrooms were toured and observed to be clean and properly furnished with appropriate dresser, beddings, and linens with sufficient lighting. Linen storage was also checked and observed to have ample supply of clean linen and towels.

Bathrooms were observed to be properly supplied and contained working fixtures; and appropriate non-slip mats and grab bars were present. Hot water temperature was measured at a range of 114.9°F to 117.1°F and within the required range. Client’s personal hygiene supplied is in a box labeled with their name locked in bathroom cabinet.