Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted an annual inspection using the CARE tools. LPA arrived unannounced and met with Administrator Della Higgins. The purpose of the visit was explained. The facility is licensed for (4) adults ages 18-59 and (2) may be non-ambulatory in bedroom #1.

LPA toured the facility and conducted the following domains:

Infection Control: The facility staff are using appropriate hand hygiene and wearing gloves while assisting clients. Staff are still cleaning and disinfecting at least once a day. Facility has sufficient PPE supplies.

Physical Plant & Environment Safety: The facility does not have any pool or bodies of water on the premises. There are 2 client bedrooms, 2 Staff rooms, 2 bathrooms, living room, dining room, kitchen, enclosed patio, and detached garage. Each client bedroom has the required furniture and bedding. Extra hygiene supplies were observed. Facility has smoke and carbon monoxide combo detectors in each room. Knives, cleaning solutions, and disinfectants are locked. There are no firearms or weapons stored at the facility. The hot water temperature in the bathroom was measured between the required range of 105-120 degrees F.

Food Service: The facility has sufficient 2-day perishable and at least a week of non-perishable food supplies stored. The foods in the refrigerator are properly covered to avoid contamination.

LPA will return to complete the remainder of the domains on a later date. An exit interview was conducted and a copy of this report was given to the Administrator.