Facility Evaluation Report

Licensing Program Analyst (LPA) Sanjay Vaid conducted the required annual inspection. LPA arrived unannounced and met with the House Manager Alex Tran, who assisted with the inspection. The purpose of the visit was explained.

The facility is licensed as an Adult Residential Facility for Persons with Special Health Care Needs (ARFPSHN) to serve five (5) adults ages 18 through 59 and five (5) may be bedridden.

LPA utilized the Compliance and Regulatory Enforcement tools for the visit today and observed the following:

Infection Control: The facility staff are using appropriate hand hygiene and gloves while assisting clients with medications. Staff are cleaning and disinfecting throughout the day. Facility has an Infection Control Plan.

Physical Plant & Environment Safety: The facility is located, in a residential neighborhood and consists of 5 bedrooms, 2 bathrooms, living room, dining room, kitchen, office area, and an attached garage. Clients’ bedrooms were toured, each client’s room has the required furniture. The hot water temperature was tested throughout the facility and measured within the required range of 105-120 degrees. The outdoor and passageways are free of obstruction. There are no security bars or bodies of water on the premises. Hygiene products are readily available. The front and back yard are free of debris/hazards.