Facility Evaluation Report

Licensing Program Analyst (LPA) Tihesha “Lynn” Smith conducted an unannounced annual/infection control visit to this facility at 12:30 pm and observed COVID signs on the front door. LPA was greeted by caregiver Elmer Urieta and temperature was taken and recorded at sign in station in living room to the right of main door. The administrator was called and arrived at 1:10 pm. LPA observed that the five (5) clients were at the facility during visit.

LPA conducted a tour of the physical plant at 1:30 pm to ensure there are no health and safety hazards and facility staff are following Title 22 Regulations and the following was noted:

Hand washing, coughing etiquette, physical distancing, and other necessary signs were posted in the bathroom and all over the facility.

The facility has six (6) bedrooms: five (5) bedrooms for clients and (1) one bedroom designated as staff room. There is a half bathroom (toilet only) near laundry area and three (3) bathrooms:(1) near bedrooms #1 and # 2 (Jack and Jill style) and two (2) bathrooms in hallway near bedrooms # 4 and #5. There is no body water in the facility.

Bedrooms All bathrooms were clean, properly supplied and had functional fixtures. Linen storage was also checked and observed to have sufficient supply of clean linen and towels.

Bathrooms were observed to be clean and sanitary with sufficient supplies. Hot water temperature range between 105 and 120-degrees Fahrenheit.

Physical plant was checked for cleanliness and condition. Facility was in good repair and observed to be clean on today’s visit.

Living/dining room was observed to be clean and furniture in good condition and adequate seating