Facility Evaluation Report

Licensing Program Analyst (LPA) Mary Flores conducted an unannounced annual using the CARE inspection tool. LPA met with Brenda Avila and explained the reason for the visit. Administrator Marites Beltran arrived 15 minutes later.

Facility is licensed to served 6 ambulatory clients between the ages of 18 to 59 years old. Facility is a single story home located in a residential neighborhood and consists of 3 client bedrooms, 1 staff room, 2 client bathrooms, a living room, a dinning room, a kitchen, an activity area, a basement inaccessible to clients, a shaded front porch, a front yard, and a back yard.

LPA Flores conducted a tour of the facility with Brenda Avila and observed the following:

Facility is in good repair indoor and outdoor. No large bodies of water were observed. Facility provides seating area in the covered front porch. Living room, activity area, and dining area have sufficient seating area and in good repair. Each room (3) has sufficient lighting, the required furniture, and bedding supplies. Two bathrooms were observed clean, in good repair. Water temperature was tested in both between 111.1 - 111.4 degrees F., which is within the required temperature of 105-120 degrees F. Kitchen area was observed clean, food supplies were observed sufficient for at least 2 days of non-perishables and 7 days of perishables. Cleaning supplies and sharps were observed locked. Medication for a resident was observed outside the medication box in the refrigerator which is accessible to the clients in care. Backyard was observed clean, passage way to the left of the facility has a few bins that may obstruct passageway. Smoke/Carbon Monoxide detectors were tested and are in working condition. Fire extinguishers were observed and last checked on 8/11/23. First aid kit was reviewed.

LPA reviewed medication, files, and P&I money for 5 clients and 5 staff files. Administrator certificate was reviewed for Marites Beltran #6033708735 exp. date: 9/4/25. Infection and Emergency Disaster plans were reviewed.

Deficiency were noted on LIC 809D per Title 22 Regulations. Exit interview was conducted with Marites Beltran and a copy of this report, LIC 809D, and appeal rights were provided.