Facility Evaluation Report

Licensing Program Analyst (LPA) Mary Flores conducted an unannounced annual using the CARE tool. LPA met with Steven Castellanos residential counselor and explained the reason for the visit. Administrator Marites Gacayan arrived 10 minutes later.

Facility is a single story home and it is licensed to served 6 ambulatory clients between the ages of 18 to 59 years old. Facility has no fences or large bodies of water. Facility has 3 client rooms, 1 staff room, 2 client bathrooms, a living room, a dinning room, a kitchen, an activity area, a basement inaccessible to clients, a shaded sitting in the front porch and a back yard.

LPA conducted a tour with Seven Castellanos and observed the following:

Facility is in good repair indoor and outdoor. Living room and dining room provide sufficient sitting space. Kitchen was observed clean and sufficient food was observed for at least 2 days worth of perishables and 7 days of non-perishables. Cleaning supplies and sharps were observed locked. Each client bedroom (3) has the required furniture and bedding, and sufficient lighting. Bathrooms (2) were observed clean and in working condition, water temperature was tested between 115.8 - 118.5 which is within the required 105-120 degrees F. Backyard is clean and front porch provides a sitting area. Smoke/Carbon monoxide were tested and fire extinguishers were observed.

LPA reviewed medication and P&I money for 5 clients and 5 staff files. LPA reviewed surety bond, Infection Control plan, and disaster plan. Administrator certificate was observed # 6033708735 exp. date: 9/4/23.

LPA conducted interviews with 2 staff and 1 client.

No Deficiencies were noted during this visit.

Exit interview was conducted with Marites Beltran and a copy of this report was provided.