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 Cory Bodda, administrator for the facility, and explained the purpose of the visit. There are twelve (15) ambulatory and six (6) non-ambulatory clients that are participants of 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.

· LPA observed that the facility has a completed infection control plan.

· The facility is a two-story building located in a residential neighborhood that is licensed for a capacity of fifteen (15) ambulatory and six (6) non-ambulatory clients between the ages of eighteen (18) through fifty-nine (59). It consists of three (3) classrooms for clients, a kitchen which also contains the washer and dryer for the facility, a backyard area, and two (2) client restrooms which had hot water temperature readings of 107.3 and 113.7 Degrees Fahrenheit respectively. A staff break room and restroom are kept in the upstairs portion of the facility. Knives along with the chemicals and cleaning supplies are kept locked and inaccessible to clients.