Facility Evaluation Report

Licensing Program Analyst (LPA) Zabel Chochian conducted an unannounced Required Annual visit and met with staff. Upon arrival LPA observed three (3) staff on duty and one (1) client in the home. Reason for visit was explained. Staff contacted Administrator and Assistant Administrator Isaac Adeleke. Administrators both arrived at approximately 12pm.

Facility is a level 4G home, vendored by Tri-Counties Regional Center serving developmentally disabled clients. Two clients require 1:1 staffing.

A tour of the physical plant was conducted with Administrator at approximately (approx.) 12pm. Smoke and carbon monoxide detectors tested and all are operable at this time. Facility has two full bathrooms designated for client use. Hot water temperature tested in one of two bathrooms (back to back) at 110 degrees. Bathrooms were observed to be in sanitary and operating condition. However, there is damage to the baseboard behind the toilet and toilet seat observed discolored. Supply of linens, towels and toiletries observed. There are five (5) bedrooms total (one bedroom for staff use). Client #4's bed and night stand observed broken at approx. 12pm. Bed and night stand needs to be replaced. Client #2's chair in room is broken (fix or replace chair). Client #3 needs chair in room. Common areas included the two living rooms that were checked: flooring and baseboard in the first living room by the lower vent observed in disrepair. Overall facility walls and baseboards of the home need to be cleaned and kept in good standing. Staff room exit sliding door screen observed at approx. 12:10pm to be torn. Screen needs to be repaired or placed.

LPA observed sharps, detergents and chemicals locked and inaccessible to clients. Sharps are kept in a locked cabinet next to the kitchen sink. Facility has sufficient two (2) day perishable and seven (7) nonperishable food supplies. Fire extinguisher in the kitchen last inspected 08/24/2022. The facility maintains a comfortable indoor temperature. The outer physical plant was clear and free of obstruction.