Facility Evaluation Report

Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year visit focusing on COVID-19 Infection Control Practices. LPA met with Administrator Zosimo Pascasio and explained the purpose of the visit. There are 23 ambulatory mentally disabled clients ages 59 and under. Facility has multiple single story detached buildings. It is located in a residential area consisting of 14 client rooms, 5 bathrooms, kitchen, dining room, laundry room, med-tech room, rear backyard, and a courtyard in the center of the property. The last fire drill was completed on Aug. 15, 2021. Administrator certificate expires 12/25/2022.

COVID-19 Infection Control Practices were observed in common areas and all client rooms.

Infection control signs, and other signs are posted throughout the facility to promote hand washing, cough/sneeze etiquette, and physical distancing.

Fourteen (14) client rooms, common areas, kitchens, bathrooms, and outdoor physical plant was inspected.

Seven (7) centrally stored 30-day client medication records were reviewed.

Staff responsible for direct care and supervision were observed wearing masks.

Clients were observed wearing masks and adhering to public health social distance guidelines.

Sufficient supply of perishable for 2 days & non-perishable foods for 7 days were observed.

A posted Emergency Disaster Plan was observed. PPE supplies were observed.

Pest control spray container was observed unlocked in the laundry room that is accessed by clients.

Cockroaches were observed on top of the kitchen counter.

Discarded mattresses, fencing, bed frames, drawer cabinets, and broken furniture was observed in the outdoor yard areas.

Deficiencies are cites according to Title 22. See 809D.

Exit interview was conducted with staff Zosimo Pascaiso. A copy of the report and appeal rights was provided.