Facility Evaluation Report

Licensing Program Analyst (LPA) Joe Katrdzhyan conducted an unannounced site visit for the Required - 1 Year inspection. Upon arriving at the facility, LPA met with Staff / Guadalupe Silva and was later joined by the Health and Services Coordinator / Elsa Montes and the Administrator / Genny Guadalquivir who assisted with the visit. The facility is licensed to serve four (4) Developmentally Disabled Clients ages 18 - 59 years. The facility is approved for Three (3) Ambulatory and One (1) Non-Ambulatory Clients. Currently, there are four (4) clients in placement. During today's visit, LPA used the infection control domain to complete the Required - 1 Year inspection. Also, the physical plant was toured, medication and food supplies reviewed.

The facility is located in a residential area. A tour of the single-story facility includes: Three (3) client bedrooms, two (2) bathrooms, recreation room, living room, kitchen, dining area, and indoor/outdoor activity areas. All medications for clients who need assistance are kept locked and inaccessible to other clients.

The bathrooms are clean and operational. Client bedrooms were checked and closet/drawer space to accommodate each client comfortably was available. The hot water temperature was tested throughout the facility. The kitchen was observed for the ability to prepare and serve food. LPA observed an appropriate food supply of two (2) days of perishables and one week (7 days) of non-perishables. All storage areas for toxins and knives are in a secured cabinet and inaccessible to residents. The facility has central air and heating accommodations. LPA reviewed client medications.

Smoke detectors and carbon monoxide detectors are operable and in compliance. The fire extinguisher was observed in the kitchen area and was fully charged. The first-aid kit is fully stocked w/First-aid Manual. The front yard is well landscaped with steps that leads to the entry. A shaded area with chairs is provided in the back yard. The backyard is free of debris/hazards and the outdoor and passageways are free of obstruction. The outdoor activity area is free of visible hazards and debris and the trash cans have covered lids. There is no evidence of bodies of water (pool) or security bars nor weapons on the premises. The washer and dryer