Facility Evaluation Report

Licensing Program Analyst(s) (LPA) Mary Flores conducted an unannounced annual visit at the facility with focus on infection control, food, and medication review. LPA met with Lerisa Cantos House Manager and explained the reason for the visit. Program Manager Katrin Silvestro arrived 20 minutes later.

Facility is licensed to serve 8 ambulatory clients between the ages of 18-59 years old. Facility is a two story house with 4 client bedrooms, 2 clients bathroom, 1 live-in staff bedroom, 1 staff bathroom, living room, dining room, kitchen, an office, detached garage, front and back porch with laundry room area, and a shaded outdoor sitting area. No large bodies of water were observed.

LPA Flores conducted the tour with Lerisa Cantos House Manager and observed the following:

Smoke/Carbon Monoxide detectors were observed, tested, and are in working condition. Fire extinguisher was observed. Sufficient food for at least 2 days worth of perishables, and 7 days worth of non-perisables in the kitchen. Sharps were locked in kitchen drawer, and cleaning supplies under kitchen's sink. Bathroom #1(B1) and #2(B2) were observed to have hand washing signs, soap, paper towels, grab bars, and skid mats (as they have some clients over the age of 60), water temperature was tested as follow: B1 tested at 112.3 degrees F., and B2 tested at 109.5 degrees F., which is within the required 105-120 degrees F. All bedrooms have sufficient lighting, all required furniture, and bedding supplies. Signs were observed throughout the facility.

LPA reviewed medication and files for 4 clients and files for 3 staff. Staff have been Fit Tested for N95 masks.

Administrator certificate was observed for Carol M. Liess #6025209735 expiration date: 2/25/23

No deficiencies were noted during this visit under Title 22 Regulations.

Exit interview was conducted with Lerisa Cantos House Manager and a copy of this report was provided.