Facility Evaluation Report

At 1:20 PM Licensing Program Analyst (LPA), Huma Rahimi, conducted an unannounced annual inspection at the facility mentioned above. LPA met with Loreto Baguio, Staff, and the Administrator Paul Tabachnikov was contacted via phone by the staff and LPA explained the reason for the visit. The Administrator informed LPA that they cannot come to the facility and designated Emerly Carino the Assistant Administrator to sign today's report. LPA and the Assistant Administrator conducted a physical plant tour and the following was observed:

The facility is a single-story home located in a residential neighborhood, contains a total of (4) client bedrooms, one (1) staff bedroom, three (3) full bathrooms, a living room/activity area, office area, kitchen, dining area, backyard, and attached garage.

Kitchen: At 1:40 PM, LPA toured the kitchen area and observed enough supplies of staple non-perishable for minimum 1 week and perishable for 2 days at the facility. All knives and sharps observed to be locked in a kitchen cabinet. The laundry room is located at the end of the kitchen and LPA observed all laundry detergents and other cleaning supplies locked in a cabinet.

Bedrooms: The facility is fire cleared for four (4) ambulatory residents. LPA observed total of five (5) bedrooms of which one (1) designated for staff, and four (4) designated for clients use. LPA observed that the staff room is always locked and inaccessible to clients in care. LPA observed extra linens in staff room closet. All bedrooms are properly furnished, clean and have appropriate bedding and linens. Facility has an awake staff. Continue on LIC809-C