Facility Evaluation Report

Licensing Program Analyst (LPA) Angelica Rea conducted an unannounced required Annual Visit. LPA was met by Direct Support Staff Aloy Ohia and explained the purpose of the visit. The facility is licensed to serve clients aged 18 to 59 years old. The facility is located in a residential area. A tour of the single-story facility includes living room, attached garage/laundry area, kitchen, dining room, 4 client bedrooms, 1 staff bedroom, 1 staff bathroom and 2 client bathrooms. Last fire drill was conducted on 11/15/23.

The following was observed : Client bedrooms #1,2,3 and 4 all contained the required furnishings and linens. Client bedroom# 4 is currently not occupied.

Client bathroom #1 was observed to be clean and well stocked with paper towels and hand soap. Water temperature in bathroom# 1 was measured at 120 degrees F which is in the required 105 – 120 degrees F. Client bathroom# 2 was observed to be clean and well stocked with paper towels and hand soap. Water temperature in bathroom# 2 was measured at 120 degrees F which is in the required 105 – 120 degrees F. Disinfectants, cleaning solutions, poisons, sharps were observed to be locked in a hallway closet and are inaccessible to clients. Kitchen was observed to be clean, and appliances were observed to operable. Nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days were observed. Fire extinguisher located near the kitchen was observed to be fully charged. Medications were reviewed, and appear to be administered as prescribed. Medications are centrally stored and locked in the dining room cabinet. Outdoor and indoor passageways are free of obstruction. There are no pools or large bodies of water on the premises.

Deficiencies on attached 809-D. Copy of report and appeal rights provided.