Facility Evaluation Report

Licensing Program Analyst (LPA) Daniel Konishi conducted an unannounced annual using the CARE inspection tool. LPA met with the Administrator, Marites Gayacan and LPA explained the purpose of the visit. Facility is licensed to serve six (6) ambulatory clients between the ages of 18 to 59 years old.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: Facility has an infection control plan in place. Hand sanitizing and infection prevention were observed at the facility. A responsible person was available at the facility.

Physical Plant & Environmental Safety: Facility is a single-story home located in a residential neighborhood and consists of three (3) client bedrooms, one (1) staff room, two (2) client bathrooms, a living room, a dining room, a kitchen, an activity area, a basement inaccessible to clients, a shaded front porch, a front yard, and a back yard. LPA toured the facility and observed that the facility is clean and in good repair indoors and outdoors. Living room, dining room have sufficient seating area. Each client bedroom has sufficient lighting, the required furniture and bedding supplies. Two (2) bathrooms were observed clean and in good repair. Water temperature was tested between 105.2 degrees F - 105.9 degrees F, which is within the required 105-120 degrees F. Second dining room was observed clean, a medication cart was observed and emergency food supplies stored in this area. LPA observed extra linens and towels are in the closet near the hallway. LPA observed no large bodies of water. Carbon Monoxide/Smoke detectors were observed. Laundry area was observed clean and in good repair. Sharps are locked and inaccessible to clients. [Continue to LIC809-C]