Facility Evaluation Report

Licensing Program Analyst (LPA) Mary Flores conducted an unannounced annual visit at the facility using the CARE inspection tool. LPA met with Christopher Heim and explained the reason for the visit.

The facility is licensed to serve six (6) Developmental Disabled adults ages 18 thru 59 years, of which two (2) can be non-ambulatory clients. Facility is a single-story home in a residential neighborhood and consist of three (3) bedrooms, office/storage room, two (2) full bathrooms, a living room, kitchen, dining area, backyard, a laundry room, and detached garage.

LPA Flores conducted a tour of the facility with Christopher Heim and observed the following:

Facility is in cleaned and in good repair inside and outdoor. Kitchen was observed and has stored sufficient food for (1) one client for at least two days of perishables and 7 days of non-perishables. Refrigerator/ Freezer was observed no thermometers available. Medication and sharps are kept in a cabinet with a lock and cleaning supplies are kept under the sink with a lock. Bedrooms (3) are shared bedrooms and have sufficient lighting, furniture, and bedding supplies. Bathrooms (2) were observed in working condition and water temperature was tested as follow in bathroom #1(inside room #1) (B1) water temperature tested at 127.0 degrees F. and bathroom #2(B2) water temperature tested at 128.9 which is not within the required 105-120 degrees F. Office space stores PPE supplies and additional cleaning supplies. The front porch serves as the shaded seating area. Backyard has seating space. Smoke/Carbon Monoxide detectors were tested and in working condition. No large bodies of water were observed. Fire extinguisher was observed. Last Fire drill was conducted on 10/1/23.

LPA checked medication, and client's file. Per staff client gets their own P&I money. LPA reviewed 4 staff files. LPA reviewed infection control plan and emergency disaster plan (version 10/03). Administrator certificate for Charlotte Heim was observed #6019004735 exp. date: 7/30/24.

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

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