Facility Evaluation Report

Licensing Program Analyst (LPA) Fernandes-Goes conducted an unannounced Annual Required – 1 yr. Infection Control inspection to this facility was welcome by staff Arturo SanJuan. Staff contacted administrator Mona Rojas who spoke on the phone with LPA during this visit. Clients were present during the visit. There is no day program at this time due to short staffing at ADP (Adult Day Program). There are activities planned for clients during the day if they want to participate and outings.

LPA arrived at the facility and observed a check in for staff and visitor’s by the entrance door. During facility tour on 7/14/2022 with staff Ivy Payumo, facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Sample of client’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguisher was found to be last charged on 10/2021 at the time of the visit. Carbon monoxide detector and sample smoke detectors test was conducted and were operational during this visit. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Food stored in refrigerator were properly stored as per regulations on this day at the time of the visit. Toxins are stored locked under kitchen sink. LPA observed that dangerous items were locked. There was a supply of cleaners, hygiene products and paper products available for clients. Sample of client’s bedrooms were inspected and had lighting & appropriate furnishings; mattress pads are available for clients at the facility. Facility hot water temperature in clients' bathroom faucet measured between 117.8 degrees F and 120 degrees F in 2 out of 2 faucets within Title 22 acceptable regulations of 105 to 120 degrees F. Disaster Drills have been conducted monthly and last dated 6/25/22.

In addition, Department is requesting an updated LIC 602 for client C1 due to a change of condition and client C2 due to concerns regarding ambulatory status by July 21, 2022.