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 Renorman Pascual and explained the reason for the visit.

The facility is licensed to serve (6) developmentally disabled clients ages 18 thru 59. Ambulatory only. The single story home is located in a residential neighborhood. Consist of 4 client bedrooms, 1 staff bedroom, 2 bathrooms, a laundry area, a kitchen, dining/living room, a detached garage, a backyard, and a front yard.

LPA conducted a tour of the facility and observed the following:

Facility is clean and in good repair indoor and outdoor. Living room/dining room has sufficient seating area. Medication cart is kept locked. Kitchen area is clean, sharps are kept in a utility box locked. Sufficient food supplies were observed for at 2 days of perishables and 7 days of non-perishables. Six client's bedrooms were observed each with sufficient lighting, the required furniture, and bedding supplies. Facility stores grooming supplies, PPE supplies and linens. Two bathrooms were observed clean, and in good repair. Water temperature was tested in each and tested between 103.0 - 108.3 degrees F., which is not within the required 105-120 degrees F. Laundry area is clean, cleaning supplies are kept in a lock cabinet in this area. Front yard and backyard were observed clean. There is no shaded seating area available. Passageways are clear and free of obstruction. There were no large bodies of water observed. Smoke/Carbon Monoxide detectors were observed and in working condition. Fire extinguishers were observed and last checked on 58/11/23.

Emergency Disaster plan was reviewed last checked on 5/2/24. Infection Control Plan was reviewed.

LPA reviewed medication, P&I money, and files for 6 clients and 5 staff files. Client #1 does not have a TB test on file.