Facility Evaluation Report

Licensing Program Analyst(s)(LPA) Mary Flores conducted an unannounced annual visit at the facility using the CARE inspection tool. LPA met with Sarah Canizales Program Technician. Administrator Cory Mitchell arrived 20 minutes later.

Facility is licensed as a Social Rehabilitation Facility to serve 6 ambulatory clients. The facility is a two story home located in a residential area and consist of 3 client bedrooms, 3 bathrooms, a staff bathroom, a kitchen, a living room, an activity room, a laundry room in the basement, a front porch, and a back yard.

LPA Flores conducted a tour of the facility with Sarah Canizales and observed the following:

Facility is clean, and in good repair inside and out. Living room, and activity room were observed to have sufficient sitting area. Kitchen was observed to store snacks for each client as the facility obtains their meals from the main kitchen. The facility has a food/meal serving waiver as part of their plan of operation. Cleaning and hygiene supplies were observed locked in a kitchen closet. Medication and sharp objects were observed locked in a closet across from staff bathroom. Each client room was observed and provides sufficient lighting, bedding supplies, and the required furniture. Each room has a bathroom in working condition and water temperature was tested between 125.4 - 130.6 degrees F., which is not within the required 105-120 degrees F.

Smoke detectors/Carbon Monoxide detectors were observed, tested, and are in working condition. Fire extinguishers were observed and last checked on 11/28/22. A fire drill was conducted on 4/23/23. No large bodies of water were observed. Backyard and front porch has shaded sitting areas.

LPA Flores reviewed files and medication for 5 clients and 5 staff files. Medications for client #4(C4) were observed without a label. During file review all 5 clients were missing a TB test clearance. Administrator certificate for Cory Mitchell needs to be renew. LPA conducted interviews with 2 staff and 2 clients.

Deficiencies were noted per Title 22 Regulations on LIC 809D.

Exit interview was conducted with Cory Mitchell administrator and a copy of this report, LIC 809D, and appeal rights were provided.