Facility Evaluation Report

Licensing Program Analyst(s) (LPA) Mary Flores conducted an unannounced annual visit with focus on infection control, food, and medication review. LPA Flores met with Veronica Moya Caregiver and explained the reason for the visit. Administrator Monique Jordan arrived 15 minutes later.

The facility is licensed to serve (6) six ambulatory developmentally disabled adults ages 18 thru 59 years old. The facility is a one story house located in a residential area and consists of four client bedrooms, two bathrooms, living room, dining room, kitchen/laundry room. There is a large front porch with sufficient shade and seating for client use and a back yard.

LPA Flores conducted a tour of the facility with Veronica Moya Caregiver and observed the following:

All passageways, walkways, driveway, steps and patio are free from obstructions. The front, back and side areas of the house are free of hazards. Fire extinguisher was observed on hallway last reviewed 7/18/22. Smoke/carbon monoxide detectors are interlace, tested and in working condition. Medication/sharps cabinet was observed in the kitchen kept under lock. Cleaning supplies are kept locked under kitchen sink. Sufficient food supplies were observed of at least 2 days of perishables and 7 days of non-perishables. Fireplace in living room was observed covered. Each client room has sufficient lighting, furniture, and bedding supplies. Bathrooms were observed without paper towels, water temperature was tested as follow; bathroom #1 water temperature tested at 110.4 degrees F., and bathroom #2 water temperature tested at 102.2 degrees F., which is not within the required 105-120 degrees F. Medication and files were reviewed for 3 clients and 3 staff files were reviewed. PPE supplies were observed for at least 30 days. Administrator certificate was observed for Monique Jordan #6043805735 expiration date: 4/6/23

No deficiencies were given during this visit. However, a technical violation and technical advisories were noted.

Exit interview was conducted with Monique Jordan Administrator and a copy of this report, and technical violation, and advisories were provided.