Facility Evaluation Report

Licensing Program Analyst (LPA) Daniel Konishi conducted an unannounced Required-1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA met with the Licensee, Gary Hall and Administrator, Daysi Galeano who assisted LPA with the visit.

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

Infection Control: The facility has an Infection Control Plan in place. Emergency Disaster Plan is current and posted. Staff will adhere to infection control requirements.

Physical Plant & Environment Safety: The facility is a single-story home in a residential neighborhood. It contains three (3) bedrooms, two and a half (2 1/2) bathrooms, a living room, kitchen, dining area, laundry area, backyard, and basement. A separate house in the back securely fenced and with a different address. Bedrooms are large enough to allow for easy passage and have the required items of furniture. There are 2 1/2 bathrooms in the home that have grab bars and non-skid mats in the shower room. There are sufficient supply of towels and linens are available to permit weekly changing are available. Sufficient personal hygiene supply available. Smoke/Carbon monoxide detectors were observed throughout the home and were tested and operable. Fire extinguisher was observed and fully charged. Cleaning solutions and sharps were locked and stored separately from where food supplies are stored. Hot water temperature readings were within the Title 22 Regulations requirement. Between 9:45am-10:02am, hot water readings were as follows: bathroom #1 at 111.3 deg F, bathroom #2 at 116.7 deg F and ½ bathroom at 111.7 deg F. The backyard has a shaded area. The interior and exterior physical plant was inspected. Exit doors are free of any obstruction and there are no pools or large bodies of water.