Facility Evaluation Report

Licensing Program Analyst (LPA) Alberto Lopez conducted the required annual inspection. LPA arrived unannounced and explained the purpose of the visit LPA met with Andy and Yelly Kohler, who assisted with the inspection today. The facility is licensed for 6 residents ages 60 and over. The fire clearance is approved for Six (6) non-ambulatory residents. Currently there are 5 residents at the facility.

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

1. Infection Control. The facility staff are using appropriate hand hygiene and wearing gloves while assisting the clients. Staff are cleaning and disinfecting each shift for high touched surface area. Facility has sufficient PPE supplies and has an Infection Control Plan.

2. Physical Plant and Environmental . The facility is a single-story house and located around the residential neighborhood area. The facility includes living room, dining area, kitchen, four clients bedrooms, 2 shared, two bathrooms, Laundry area and an detached garage. LPA inspected the carbon monoxide detector and is working probably. The smoke detectors are in each room and common area, and they are working. LPA tested the hot water temperature in two bathrooms and kitchen, and they were tested between 109.2-114.9 degrees F. which is within the Title 22 regulation. All the sharp knives and utensils are locked in the kitchen cabinet. All the cleaning supplies and chemicals are locked in the laundry room. The facility has sufficient personal hygiene products for clients to use. All clients rooms are not completely furnished with chairs and have required beddings. All the bathrooms are clean, sanitized, and operational. The exit and passageway is safe and clear of obstructions.

3. Operational Requirements. The facility maintained a fire clearance approved by the fire department which 6 may be non-ambulatory. Currently All the clients in the facility are non-ambulatory. The facility also has shaded area with table and chairs for client to utilize for outdoor activity. The last fire/disaster drill was conducted on 12/013/23.