Facility Evaluation Report

Licensing Program Analyst (LPA) Erik Zaragoza conducted an unannounced Required 1-year visit using the full Compliance and Regulatory Enforcement (CARE) Tools. LPA met with Crysel Sanots, administrator for the facility, and explained the purpose of the visit. Administrator Diana Gonzalez arrived shortly thereafter. There are four (4) clients residing in the facility.

The following 12 (CARE) tool domains were observed and reviewed: Infection Control, Physical Plant/Environment Safety, Operational Requirements, Staffing, Personnel Records/Staff Training, Client Rights/Information, Client Records/Incident Reports, Food Service, Health Related Services, Incident Medical and Dental, Disaster Preparedness, and Emergency Intervention.

· Facility has an infection control plan on file.

· The facility is a single-story home located in a residential neighborhood that is licensed for a capacity of four (4) bedridden clients between the ages of eighteen (18) through fifty-nine (59). It consists of four (4) client bedrooms, a kitchen that also contains the facility washer and dryer, a dining room, a living room, two (2) client bathrooms of which Restroom #1 had a hot water temperature reading measured at 114.8 Degrees F, and Restroom #2 had a hot water temperature reading at 118.1 Degrees F, and an attached garage which contains the emergency food supplies for the facility. Knives are kept locked in a cabinet in the kitchen of the facility, and the chemicals and cleaning supplies are kept locked in the laundry room of the facility. A shaded outdoor area was available for clients in the backyard of the facility.