Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the required annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA arrived unannounced and met with Staff, Sandra Alcala. The purpose of the visit was explained. The house manager, Alicia Federspiel, arrived shortly after to assist with the visit. The facility is licensed for (5) adults, ages 18 - 59, of which 1 may be non-ambulatory.

LPA toured the facility and conducted the following domains:

Infection Control: The facility staff are using appropriate hand hygiene and wearing gloves while assisting clients. Staff are cleaning and disinfecting at least twice a day and more often for high touched surfaces. Facility has sufficient PPE supplies. The facility had previously submitted the Infection Control Plan.

Physical Plant & Environment Safety: The facility does not have any pool or bodies of water on the premises. There are 5 client bedrooms, 3 bathrooms, living room, kitchen, and attached garage. Each client bedroom has the appropriate furniture, storage space, and lighting. Extra hygiene supplies were observed. Facility has an operable smoke detector in each room and a carbon monoxide detector. Knives, cleaning solutions, and disinfectants are locked. There are no firearms or weapons stored at the facility. The hot water temperature was measured between the required range of 105-120 degrees F.

Operational Requirements : The facility is operating within the fire clearance approval. Staff are providing care and supervision to meet the clients' needs and assisting in activities of daily living.

Food Service: There are sufficient food supplies of 2 day perishable and a week of non-perishable items observed. Foods are properly stored in the refrigerator to avoid contamination.

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 the house manager.