Facility Evaluation Report

Licensing Program Analyst (LPA) Sakinah Madyun and Out of Class Licensing Program Manager (LPM) Mary Flores conducted an unannounced annual visit at the facility using the CARE inspection tool. LPA met with Imelda Jonson and explained the reason for the visit.

Facility is licensed to serve 9 ambulatory clients between the ages of 18-59 years old. Facility is a two story house with 5 client bedrooms, 2 client bathrooms, 1 downstairs live-in staff bedroom, 1 downstairs staff bathroom, living room, dining room, kitchen, an office area, detached garage, front and back porch with laundry room area, and 2 shaded outdoor sitting areas.

The following CARE tool domains were reviewed during this visit:

Infection Control: An infection control plan was reviewed. Hand sanitizing and infection prevention were observed at the facility. A responsible person was available at the facility.

Physical Plant & Environmental Safety: LPA toured the facility with Imelda Jonson Facility Manager. Kitchen was observed clean. A knives and scissors were observed in a cabinet locked and inaccessible to the clients. The living room has a covered fireplace. LPA observed a total (5) client bedrooms, each was observed with sufficient lighting, bedding supplies, and furniture. LPA observed (2) bathrooms in good repair and water temperature was tested at 118.4 degrees F., which is within the required 105-120 degrees F. Carbon Monoxide/Smoke detectors were tested and are in working condition. Laundry area was observed in good repair. 2 shaded tables with chairs were observed in the backyard. Passageways and exit areas were observed free of obstruction. No large bodies of water were observed.