Facility Evaluation Report

Licensing Program Analysts (LPAs) Erik Zaragoza and Mayra Cota conducted an unannounced Required 1-year visit using the full Compliance and Regulatory Enforcement (CARE) Tools. LPA met with Lesly Mendoza, Direct Support Staff (DSP) for the facility, and explained the purpose of the visit. Administrator Brenda Venegas was notified of the visit. 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.

· Infection control practices and Personal Protective Equipment (PPEs) were observed. LPA observed that the facility has a completed infection control plan.

· 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) and fifty-nine (59). It consists of four (4) client bedrooms, a kitchen, a laundry room, a dining room, and two (2) client restrooms of which Restroom #1 which had a hot water temperature reading of 119.5 Degrees Fahrenheit, and Restroom #2 had a hot water temperature of 120 Degrees Fahrenheit. Knives along with the chemicals and cleaning supplies are kept locked and inaccessible to clients. A shaded outdoor area was available for clients.

· The interior and exterior physical plant was inspected. Exit doors are free of any obstruction. There are no pools are or bodies of water accessible to the clients. Fire alarm system is operational. The facility has two (2) fully charged fire extinguishers that is kept in the facility. Cleaning supplies and toxic substances are kept locked and inaccessible to clients.