Facility Evaluation Report

Licensing Program Analyst(s) (LPA) Mary Flores conducted an unannounced annual visit at the facility with focus on the infection control domain, medication and food review. LPA met with Luther Waters and explained the reason for the visit.

Facility is licensed to serve one (1) ambulatory and two (2) non-ambulatory clients between the ages of 18 - 59 years old. The home is equipped with a sprinkler system and interlace smoke/carbon detector throughout the facility which were tested and working properly. The home has a kitchen, a living room, a dining room, 3 bedrooms, 2 bathrooms, a back yard, front porch, and a detached garage. There are no large bodies of water in the facility.

LPA Flores tour the facility with Luther Waters - administrator and observed the following:

Living room has a glass covered and seal fireplace. Kitchen has sufficient food supplies at least 2 day supplies of perishables and 7 days non-perishables. Sharps and cleaning supplies are under a magnetic lock under the sink and a cabinet above the washer and dryer. A bug spray was observed in an unlock cabinet and 3 screwdrivers were observed in an unlock cabinet. Medication is kept under a magnetic lock above the refrigerator. All bedrooms have all furniture, bedding, and sufficient lighting. Bathrooms are in working condition water temperature was tested at 11.5 degrees F in both, which is under the required 105 - 120 degrees F.

Facility is following COVID 19 recommendations regarding screening visitors, staff, and clients. Facility has placed a request with Department of Public Health to obtain N95 Fit testing. Signs are posted throughout the facility. Handwashing signs are posted by the sinks, and available hand soap, paper towels were observed. PPE supplies were observed facility is to obtain additional gloves and surgical mask.

Deficiency was given during this visit under Title 22 Regulations. Exit interview was conducted with Luther Waters administrator and a copy of this report, 809D, Technical Advisory Note, and appeal rights were given.