Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the required annual inspection with the focus of the infection control domain. LPA met with DSP staff and explained the purpose of the visit. The facility is approved for six (6) non-ambulatory developmentally disabled adults, ages 18 - 59. There are currently 4 clients residing at the home.

LPA Chan toured the facility and observed the following:

* There are 5 bedrooms (3 Client bedrooms and 2 vacant rooms designated as isolation rooms), 3 bathrooms, living room, dining area, kitchen, and an attached garage. There are no obstructions to the passageways and no bodies of water.

* The facility has proper Coronavirus (COVID-19) signage at the main entrance and around the home. Hand washing signs are posted in the bathrooms and sink.

* Staff are screening all visitors and documenting their temperature. Staff and clients' temperature are also taken daily and documented.

* Sufficient PPE supplies are stored at the facility.

* The smoke detectors and carbon monoxide detector were tested and operable.

* Food supplies for 2 day perishable and a week of non-perishable were observed.

* Knives and sharps are stored and locked in the kitchen.

* Medications are centrally stored and locked. LPA reviewed all 4 medications and did not observe any deficiencies.

* Per Staff, they are still following the COVID-19 guidance and also clean and disinfect high touched surfaces on every shift.

* The hot water temperature were measured over 120 degrees Fahrenheit in the kitchen sink and bathrooms. The hot water temperature should be maintained between 105-120 degree.

The deficiency is issued on the LIC809D. Exit interview held and a copy of this report was provided.