Facility Evaluation Report

Licensing Program Analyst(s)(LPA) Mary Flores conducted an unannounced annual visit using the CARE tool at the facility. LPA Flores met with Silvina Gomez caregiver and explained the reason for the visit. Administrator Desiree Alvarado arrived 40 minutes later.

The facility is licensed to served 14 ambulatory mentally ill clients between the ages of 18 to 59 years old. The facility is a two story home in a residential area and consist of; first floor: a living room, a kitchen, 2 client rooms, laundry area, 1 bathroom, an office with access to the basement, and a staff room. Second floor: 7 client bedrooms, and 2 bathrooms. A backyard, a front yard, a detach garage and a shed.

LPA Flores conducted a tour of the facility with Silvina Gomez caregiver and observed the following:

First floor: Living room has sufficient sitting area, a covered fireplace. Kitchen was observed and a medication cabinet was observed, sharps were observed in a drawer to the left of the sink, kitchen is maintain lock when staff is not in the kitchen. Medication and knives are inaccessible to the clients. All bedrooms have sufficient lighting, bedding supplies, and furniture. Bathrooms are in working condition and water temperature was measured between 105 - 113.1 degrees F., which is within the required 105-120 degrees F. Fire extinguishers were observed last checked on 7/9/22. Smoke/carbon monoxide detectors were checked and in working condition. Backyard has a cover sitting area. LPA Flores reviewed medication and interview 3 clients, and interview 2 staff present at the time of the visit. LPA reviewed 5 client files and 4 staff files available. Client files were missing TB test for client #1(C1),#2(C2),#4(C4), and #5(C5). Staff files did not have current first aid or training provided for staff#1(S1),#2(S2),#3(S3),#4(S4). Administrator does not have a current HIV/TB training within the last 2 years. LIC 610D (10/03) was reviewed, licensee will update to LIC610D(12/21). Certificate was observed for Desiree Alvarado #6004637735 exp: 12/16/23 and a copy of liability insurance was requested.

Deficiencies will be noted on LIC 809D per Title 22 regulations.

Exit interview was conducted with Desiree Alvarado administrator and a copy of this report, LIC 809D, technical advisory,and appeal rights were provided.