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 DSP staff Gladis Escobar and explained the purpose of the visit. There are five (5) level 3 developmentally disabled clients ages 59 and under. Facility is a two-story home licensed for 6 ambulatory only clients. It is located in a residential area consisting of four (4) client bedrooms, (2) staff rooms, 3 bathrooms, kitchen, dining room, living room, family room, covered patio area, and attached garage with laundry area. The last fire drill was completed on 12/14/2021.

COVID-19 Infection Control Practices were observed upon entry and in common areas.

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

Room #2 is designated as COVID-19 isolation room if needed.

Hand sanitizer was observed in common areas.

Staff responsible for direct care and supervision were observed wearing a mask.

Clients were not observed wearing masks in the home due to cognitive impairment.

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

A Emergency Disaster Plan was posted. Please update if needed.

Sufficient supply of Personal Protective Equipment (PPEs) was observed.

Centrally stored medication records were reviewed. Client (C1) did not have a Health Care Restriction Plan for Diabetes.

Exit interview was conducted with staff Gladis Escobar. A copy of the report and appeal rights were issued.