Facility Evaluation Report

Licensing Program Analyst (LPA) Daniel Konishi conducted an unannounced Required 1-year visit using the full Compliance and Regulatory Enforcement (CARE) Tools. LPA met with Adam Elias, Direct Support Staff (DSP) and LPA explained the purpose of the visit. Staff, Alan Banuelos arrived shortly after and assisted with the visit. The facility is licensed for a capacity of four (4) bedridden clients in rooms #1 to #4 and between the ages of eighteen (18) and fifty-nine (59). There are four (4) clients residing in the facility.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. LPA observed that the facility has an Infection Control Plan in place.

Physical Plant/Environment Safety: 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 bathrooms. LPA inspected residents’ rooms and each resident bedroom has the required furniture such as bed frames, dressers, nightstand, lamps, and chairs. Bedrooms also have sufficient closet space. Extra linens and towels are in each resident's bedroom closet. Exit doors are free of any obstruction and there are no pools or large bodies of water. The two (2) bathrooms contain a working toilet, basin, and water faucet, walk in shower with grab bar, shower chair, non-skid mat, and bathmat. The hot water temperature readings measured 105.2 deg F in bathroom #1 and 107.6 deg F in bathroom #2 which are within the required 105-120 degrees Fahrenheit. Sharps are kept locked and inaccessible to clients.