Facility Evaluation Report

Licensing Program Analyst (LPA) Noemi Galarza made an unannounced annual inspection visit. The purpose of the visit was explained to caregiver staff Flordeliza Rosana. The facility is an Adult Residential Facility (ARF) that serves mentally disabled residents ages 59 and under. It consists of 4 bedrooms [ 3 resident & 1 live-in staff room], 2 bathrooms, kitchen, dining room, living room, attached 2-car garage with laundry area, and outdoor patio area. The following 12 (CARE) tool domains were utilized during the inspection.

Infection Control: T he facility staff are using appropriate hand hygiene cleaning and disinfecting the home. An Infection Control Plan was reviewed.

Physical Plant/Environment Safety: The interior and exterior physical plant was inspected .Exit doors are free of any obstruction and there are no pools or large bodies of water. Smoke and carbon monoxide detectors we re tested and are operation. The facility has one (1) fully charged fire extinguisher. Hot water temperature readings measured between the required 105 - 120 degrees Fahrenheit. Storage areas for cleaning solutions/toxins, knives, and hazardous items were inaccessible to clients.

The stove burners are not in safe working condition because staff are using matches to ignite the burners. The backyard had discarded furniture, wood planks, boxes, and large tree sticks. The stucco on the right side and back of the house has large areas missing stucco. A citation was issued.

Two (2) beds did not have required mattress pads. A citation was issued.

Operational Requirements: The Program Design was reviewed. Fire clearance is approved for six (6) non-ambulatory clients. Care and supervision to meet the clients needs was observed. No special equipment and supplies are used by clients. Surety Bond is not applicable. Clients handle their own money.