Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Wong conducted an annual required visit. LPA met with DSP Ambrose Metu and explained the reason for the visit and assisted LPA with the tour of the visit. LPA spoke with the administrator Angela Porter on the phone. LPA used the infection control tool to evaluate the facility. LPA's observed the facility plant, COVID-19 procedures and observed food supply Facility has submitted a mitigation plan and was approved on 05/15/2021

The facility is a one story house and located in a residential neighborhood area. The facility included kitchen, dining room, living room, four clients bedrooms, two bathrooms and an attached garage. All 4 clients bedrooms were toured. Each bedroom has one bed, one chair, closet , required linen, dresser and sufficient light. All 2 bathrooms were toured and they are operational, clean, sanitary and free of odors. At 12:00pm, the hot water temperature for both bathrooms were measured at 124.8 degrees which is beyond the required 105 - 120 degrees. The refrigerator and pantry in the kitchen has sufficient two days perishable and seven days non perishable food. All the appliances are clean and working properly. The common areas such as living room and dining room are clean and have the required furniture. The front and back yard are maintained well. The front yard has a shaded area and sitting area for clients and visitors to use. LPA also inspected the smoke detectors and carbon monoxide detectors and they are operational.

Facility is currently following COVID 19 recommendations regarding COVID 19 signs throughout the facility, disinfecting products are available in each room and facility is disinfected every shift or as needed, the bathrooms have sufficient soap, paper towels, and signs and PPE supplies are stored for 30 days.

The deficiencies cited are documented on the attached 809D. A copy of the report and appeal rights will be provided to DSP Ambrose Metu