Facility Evaluation Report

At approximately 8:45AM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a Required 1 Year visit and met with Staff Member, Abraham Gebru. Facility is an Adult Residential Home that provides care and assistance for Adults with Disabilities. Facility has an approved fire clearance and capacity for 6 Ambulatory clients. Upon arrival, LPA was informed that there are 6 clients in care, and all six clients were out of the community attending Day Program. LPA was also informed that there was 1 staff member on site. Associate Director of Residential Services, Stacy Anderson, arrived later during visit at approximately 9:30AM.

At approximately 9:00AM, LPA reviewed the facility's Staff Roster with Staff Member and found that all staff members on site were background cleared and associated to the facility per regulation. At approximately 9:15AM, LPA conducted a walk-though of the facility with Staff Member and Assistant Administrator. LPA observed the following: The facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Facility is a two story building with 6 bedrooms, 3 bathrooms, a kitchen, dining room, living room, and 1 staff office room. Facility has a mitigation plan on file. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Toxins were observed to be stored inaccessible to clients. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for clients. Hot water temperatures for all sinks in facility were within Title 22 regulations of 105 to 120 degrees Fahrenheit.

During walk though, LPA observed that one of the client bathrooms had sheet rock exposed and duct tape against the bathtub, and some water damage (See Technical Advisory - Regulation 80088(e)(3)). Per conversation with Associate Director of Residential Services, the duct tape and damage to the wall has been there for a few months. The facility is expecting to replace the bathtub with a shower and repairs are expected to start today, 07/24/2023. LPA obtained pictures and requested that once repair is complete that a picture is sent in to Community Care Licensing (CCL).

LPA also observed that one of the client bathrooms did not have a lid on their trashcan. LPA observed that the trashcan was empty and there was no distinguishable odors in the bathroom. Staff immediately replaced trashcan with one that had a lid.