Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA arrived unannounced and met with Staff, Mirna Alderete. The purpose of the visit was explained. Administrator, Jose Alderete, arrived shortly thereafter to assist with the visit. The facility is licensed for (3) adults, ages 18 - 59, and of which (1) may be non-ambulatory.

LPA toured the facility and conducted the following domains during the visit today:

Infection Control: The facility staff are using appropriate hand hygiene and wearing gloves when necessary. Staff are continuing to clean and disinfect during each shift and more often for high touched surfaces. Facility has sufficient PPE supplies.

Physical Plant & Environment Safety: The facility does not have any swimming pool or bodies of water on the premises. There are 3 client bedrooms, 1 administrator's office, 2 bathrooms, living room, dining area, kitchen, and an attached garage. Each client bedroom has the required furniture and bedding. Extra hygiene supplies and linens are observed. Knives, cleaning solutions, and disinfectants are locked, making them inaccessible to clients. There are no firearms or weapons stored at the facility.

Operational Requirements: The facility is operating within the approved fire clearance. There are 3 ambulatory clients residing at the home. Staff are providing the care and supervision as necessary to meet the clients' needs.

Food Service: There are sufficient food supplies of 2 day perishable and a week of non-perishable. The kitchen is clean and free of pests.

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 Administrator Alderete.