Facility Evaluation Report

Licensing Program Analyst (LPA) Mary Flores conducted an unannounced annual visit at the facility using the CARE inspection tool. LPA contacted Leah Avila Administrator over the phone and explained the reason for the visit. Staff Aida Tabucal arrived shortly after and assisted with the visit.

Facility is licensed to serve 6 ambulatory clients age range from 18-59 years old. The physical plant consist of a single family home, a kitchen, a dining room, a living room, (4) bedrooms; of which (3) are shared client bedrooms, and (1) staff room, (2) bathrooms, a laundry area, a garage, a porch with shaded sitting area, and a backyard area.

LPA toured the facility with staff and observed the following:

Home is in good repair indoor and outdoor. Living room and dining room have sufficient furniture. Kitchen is clean. Sharps, medication, and cleaning supplies were observed locked. Food supplies were observed sufficient for at least 2 days of perishables and 7 days of non-perishables. Laundry room was observed and emergency food supplies are store in cabinets above the washer/dryer. Each client room (3) has sufficient lighting, furniture, and bedding supplies. Each bathroom is in working condition with grab bars and skid mats, water temperature was tested between 105-106.5 degrees F. which is within the required 105-120 degrees F. Carbon Monoxide/Smoke detectors were tested and are in working condition. Fire extinguisher was observed and last checked on 6/5/23. Backyard is clean, shaded covered sitting area is available in the porch.

LPA reviewed medication, P&I, and files for 5 clients and 5 staff files. Infections control plan was last reviewed on 6/13/23. Emergency Disaster Plan was reviewed, no date of last reviewed. Last fire drill was conducted on 11/1/23.

No Deficiencies were noted during this visit. A technical assistance was recorded.

Exit interview was conducted with Aida Tabucal a copy of this report was email for signature due to technical issues during the visit.