Facility Evaluation Report

Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. The purpose of the visit was explained to Assistant Administrator Danielle Maximo. Administrator Rose Maximo arrived later. There are currently 4 developmentally disabled residents 60 years and older residing in the facility. None of the residents are receiving hospice care, home health, or have Dementia. The inspection was completed using the CARE tools. Twelve (12) CARE tools domains were reviewed.

Visitors are no longer being screened for COVID-19, but are still required to sign in. The facility has an Infection Control Plan and Covid-19 Mitigation Plan. Infection control practices and Personal Protective Equipment (PPEs) were observed.

A current Plan of Operation was reviewed.

The facility has a Dementia Waiver in place. A Hospice Waiver for 4 is approved.

A fire clearance for 6 non-ambulatory adults 60 and over is in place.

Liability Insurance in the amount of at least ($1,000,000) per occurrence and ($3,000,000) in total annual aggregate is current.

Facility handles resident's P & I monies. A Surety Bond of $2,000 is current.

***See next page for report narrative.***