Facility Evaluation Report

Licensing Program Analyst (LPA) Tena Herrera conducted the required annual inspection. LPA arrived unannounced and met with Concepcion Pacania (Lead Staff) and explained the reason for the visit. The facility is licensed to serve Six Developmentally Disabled (DD) Adults and Room #4 is approved for 2 Non-Ambulatory.

The facility is a single-story home located in a residential area consisting of: three (3) client bedrooms, (2) Staff Bedrooms, 2 bathrooms, kitchen area, dining area, living room, covered patio area, and a detached garage.

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

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

Physical Plant & Environment Safety: There are 3 client bedrooms, 2 staff bedrooms, 2 client bathrooms, living room, kitchen, dining area. Clients’ bedrooms were checked and closet/drawer space to accommodate each client comfortably was available. The outdoor and passageways are free of obstruction. There are no security bars or weapons on the premises. Hygiene products are readily available and stored in hallway closet. The hot water temperature was tested in both client bathrooms. The water temperature measured between 113.5-114.6 degrees F, these are within the required range of 105-120 degrees. Both front and back yard are free of debris/hazards. All storage areas for cleaning solutions, and toxins are stored in a locked cabinet under the kitchen sink. The knives and sharp items are securely stored in a locked drawer in the kitchen.