Facility Evaluation Report

Licensing Program Analyst (LPA) Alviso conducted a Required- 1 Year visit, on 9/18/23 at approximately 10:00am, and met with Licensee/Administrator Norbert Sacro. LPA observed two caregivers on duty during the inspection.

Facility has an emergency disaster plan as required. Facility has an infection control plan as required. There are currently six(6) residents in care. The LPA reviewed six (6) resident files.

The LPA reviewed four (4) staff files. All staff have criminal record clearance as required. Administrator Norbert Sacro has a current administrator certificate- expires 10/31/2024.

LPA toured the facility with the Administrator. All exits were free and clear of obstruction. All exit doors had auditory alarms and the alarms were working properly during the inspection. Fire extinguishers, two(2), were serviced and tagged as required, expires 7/1/24. Facility was at a comfortable temperature; LPA observed three residents watching tv upstairs in the living room. LPA observed one resident eating their meal in the downstairs common area room. LPA observed two resident rooms upstairs, and two resident rooms downstairs. On each floor one of the resident rooms is a shared room. There was a sufficient supply of hygiene products, cleaning supplies, and paper products for use as needed. Facility has a sufficient supply of personal protective equipment(PPE) for use as needed. LPA observed sufficient supply of food, perishable and non-perishable. Medications were stored and locked making them inaccessible to residents. All toxins and cleaners were stored in locked cabinets, and inaccessible to residents in care.

LPA is requesting the following documents be updated and submitted by 10/18/23:

LIC308 - Designation of Administrator Responsibility

LIC610E-Emergency Disaster Plan (ensure to provide all information in all boxes as required)

Copy of LIC400 Handling of Client Cash Resources- complete and submit

Include copy of surety bond (if handling cash)

Copy of current Administrator Certificate