Facility Evaluation Report

Licensing Program Analyst (LPA) Helena Rummonds arrived unannounced at approximately 9:10AM to conduct an Annual Required inspection and was greeted by Administrator, Jasmin Gongora. LPA and Administrator discussed the purpose of the visit.

LPA and Administrator initiated a tour of the facility around 09:25 AM and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Resident rooms were furnished per regulation. Water temperature in sinks accessible to clients measured at 116 degrees F which is within the range of 105 to 120 degrees F allowed per regulation.

Extra hygiene products and linens were available. Cabinets containing cleaning supplies were locked. Sharps were locked and facility keeps a check in log to ensure that sharps are returned and accounted for. Facility has at least two days of perishable and one week of non-perishable foods which were of quality and stored per regulation. Medications were centrally stored and locked. Emergency food and water is stored in the garage. Personal Protective Equipment is stored in the garage. LPA and Administrator observed a broken glass bottle in the side yard. Administrator immediately disposed of it.

Facility has smoke and carbon monoxide detectors located throughout the facility as well as a sprinkler system. LPA did not test the alarms at the time of inspection as clients were in the facility and loud noises can be a trigger for behaviors. LPA and Administrator discussed testing them quarterly and keeping a log reflecting whether or not they were operational. Administrator informed LPA that maintenance comes out to replace the batteries yearly. LPA and Administrator discussed that during their next fire/disaster drill, they will test the smoke/carbon monoxide alarms and let LPA know the results of the test. Fire/disaster drills are conducted monthly with the last one taking place on 03/01/2024. Facility does not handle client cash resources at this time.