Facility Evaluation Report

Licensing Program Analyst (LPA) Erik Zaragoza conducted a subsequent unannounced Required 1-year visit using the full Compliance and Regulatory Enforcement (CARE) Tools. LPA met with Les Eve, administrator for the facility, and explained the purpose of the visit.There are four (4) ambulatory clients currently residing in the home.

The following 12 (CARE) tool domains were observed and reviewed: Infection Control, Physical Plant/Environment Safety, Operational Requirements, Staffing, Personnel Records/Staff Training, Client Rights/Information, Client Records/Incident Reports, Food Service, Health Related Services, Incident Medical and Dental, Disaster Preparedness, and Emergency Intervention.

· Infection control practices and Personal Protective Equipment (PPEs) were observed. LPA observed that the facility has a completed infection control plan.

· The facility is a single-story home located in a residential neighborhood that is licensed for a capacity of four (4) ambulatory clients between the ages of eighteen (18) through fifty-nine (59). It consists of two (2) client bedrooms, an office, a staff room, a kitchen, a dining room, a living room, an attached garaged that contains the facility’s emergency food supply, and one (1) client bathroom which had a hot water temperature reading of 108.7 degrees Fahrenheit. Knives along with the chemicals and cleaning supplies are kept locked and inaccessible to clients in the garage of the facility as well as in the kitchen cabinets. A shaded outdoor area was available for clients in the backyard of the facility.