Facility Evaluation Report

Licensing Program Analyst (LPA) V. Maldonado made an unannounced visit at the facility for the purpose of conducting the required annual inspection, using the Compliance and Regulatory Enforcement (CARE) Tool, to evaluate the facility. LPA Maldonado met with Program Director (PD), Irma Swenson, and explained the purpose for the visit.

During today's visit, LPA Maldonado conducted a tour of the physical plant with PD, reviewed (5) client files, and (5) staff files. The facility is a single story building, operating as an Adult Day Program. It is licensed to serve (30) Developmentally Disabled adults, ages 18-65. There is a fire clearance approved for (20) non-ambulatory clients, of which (6) may use wheelchairs and (4) may use walkers only. Hours of operation M-F 7AM to 5PM. An approved mitigation plan is in place and Infection Control plan has been submitted to the department for review.

LPA observed activity rooms to be clean and free of hazards. Bathrooms were observed to have the required grab bars and were free from odors. The hot water was tested and measured at 114*F, which is in compliance. Clients provide their own lunch and snacks. The facility does not store client medications and/or assist with medication administration. The facility does not store or assist clients with Personal and Incidental funds. Sufficient staff were observed to provide care and supervision to the clients in care at all times. Fire extinguishers were observed throughout, with current inspections and were fully charged. All sharps and cleaning supplies/toxins were observed to be locked and inaccessible to clients in care. The last emergency disaster drill was conducted on 01/05/24 and last fire drill was conducted on 04/06/24 . S moke/Carbon monoxide detectors were observed in every room and operational. No bodies of water were observed on the premises. Emergency food and water supplies were observed and readily available. LPA reviewed (5) client files and discovered that Client#4 (C4) has an admission agreement on file, but is not completed and signed by C4, as required. It was also discovered that Client#5 (C5) does not have an admission agreement or a current IPP on file. (5) staff files were reviewed and observed to be complete with all required documentation. Staff files were observed to have proof of current CPR/CPI/AED certification.

Deficiencies were observed during today's visit and will be cited on the LIC809-D page.

An exit interview was conducted and a copy of this report and appeal rights were provided.