Facility Evaluation Report

Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit and was greeted by Caregiver Juana Becker and explained the reason for the visit. Shortly thereafter Administrator Mylene Bumanlag arrived. The purpose of the visit is to complete the required inspection.

LPA Trueman toured the facility along with Staff Juana Vecker today 08/15/2023 at 9:20 AM and the following was observed

Facility contains 4 Client Bedrooms and 2 client bathrooms dining room, kitchen, and TV room.

Required Annual Inspection included Infection Control Practices, Operational Requirements, Physical Plant/ Environmental Safety, Staffing, Personnel Records/ Training, Client Rights- Information, Client Records- Incident Reports, Food Service, Health Related Services, Incidental Medical Services, Disaster preparedness, and Emergency Intervention.

LPA observed sufficient supply of 2 day perishables and 7 day non perishables. All staff were cleared and associated.

Visitation signage was posted along with signage for hand washing and proper sanitizing.

Licensee maintained an individual admission agreement for each client.

Each client has personal rights free from corporal or unusual punishment, infliction of pain, humiliation, ridicule, coercion, threats, mental abuse, or other actions of a punitive nature.

Facility was clean, safe, sanitary, and in good repair at all times for the safety and well being of clients, employees and visitors.

Medication was reviewed and was given per physician's directions.

4 Client Files and 6 Staff Files were reviewed.

Interviews were conducted with 1 Staff and 1 client. 3 client's were at day program.

Hot water temperature measured 140 F. and was not between 105 F. and 120 F. and did not meet Title 22 Regulations.

Deficiency cited on 809 D. Exit interview conducted and copy provided.