Facility Evaluation Report

Licensing Program Analyst (LPA) Mary Flores conducted an unannounced annual visit at the facility using the CARE inspection tool. LPA met with Silvina Gomez and explained the reason for the reason.

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 TV/ dining 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 conducted a tour with Silvina Gomez and observed the following:

Facility is in good repair indoor and outdoor. TV/dining room sufficient seating area, clean, fireplace is covered. A computer with access to the internet and a telephone were observed in TV room area. Kitchen is clean, knives are stored in a drawer and cleaning supplies under sink, medication cabinet was observed.Kitchen is inaccessible to the clients. Sufficient food supplies were observed for at least 2 days of perishables and 7 days of non-perishables.

Client's rooms (8) were observed each with sufficient lighting, furniture, and bedding supplies. Bathrooms (3) were observed clean, in good repair, and water temperature was tested between 116.2 - 132.6 degrees F., which is not within the required 105-120 degrees F. Laundry area was observed next to room #2. Detached garage is used to stored supplies and additional food. The backyard has a covered sitting area and there is a front porch with furniture. Carbon monoxide/ smoke detectors were tested and are in working condition. Fire extinguishers were lasted checked on 3/14/24. Stairs and passageways were clear of debris and obstructions. The facility has two stairways, one indoor and one in the exterior. LPA did not observed evacuation chairs either at the top or bottom of those stairways.

LPA reviewed medication and files for 5 clients and 5 staff files. LPA conducted interviews with 2 clients and 1 staff. (CONTINUED ON LIC 809C)