Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA arrived unannounced and met with Staff, Christine Takata. The purpose of the visit was explained. Administrator, Arlisha York, arrived at 3:20pm to assist with the visit. The facility is licensed for (4) ambulatory clients, ages 18 - 59.

LPA toured the facility and conducted the following domains:

Infection Control: The facility staff are using appropriate hand hygiene and wear gloves when needed to assist clients. Staff are cleaning and disinfecting at least once a day and more often for high touched surfaces. Facility has sufficient PPE supplies.

Physical Plant & Environment Safety: The facility does not have any pool or bodies of water on the premises. There are 3 client bedrooms, 2 bathrooms, living room, dining area and open kitchen, and an attached garage. Each client bedroom has the required furniture and bedding. Extra hygiene supplies and linens are observed. The smoke detectors are interconnected and the carbon monoxide detector are operable. Knives, cleaning solutions, and disinfectants are locked, making them inaccessible to clients. There are no firearms or weapons stored at the facility.

Operational Requirements: The facility is operating within the approved fire clearance. Staff are providing the care and supervision as necessary to meet the clients' needs.

Food Service: There are sufficient food supplies of 2 day perishable and a week of non-perishable. The kitchen is clean and free of pests.

LPA also checked the medication for 3 clients and they are being administered as prescribed by the physician.

LPA will return to complete the remainder of the domains on a later date. An exit interview was conducted and a copy of this report was given to Administrator York.