Facility Evaluation Report

Licensing Program Analyst (LPA) Edward Tapia made an unannounced required annual inspection at this facility. LPA met with Administrator Michelle Domingo and stated the purpose of this visit.

The facility is a single level dormitory style structure and licensed for four non-ambulatory clients. This facility is an Adult Residential Facility for the Mentally Disabled.

At about 1:50 PM, LPA Tapia was granted entry after completing the Coronavirus 2019 (COVID 19) screening procedure. For this visit, LPA observed clients in the front entry of the facility. LPA toured the interior and exterior portions of the facility. There were 2 separate halls which housed male clients on one side and female clients on the other. Client rooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Client rooms observed contained sinks with hand washing signs posted nearby. Administrator provided reports for fire alarms which were last tested on 05/25/2022. Carbon monoxide alarms were tested on 07/22/2022. Facility offers common restrooms with showers. Restrooms were observed to be in good repair and provided with grab bars and hot water was measured between 113.9 degrees to 114.6 degrees Fahrenheit. Facility met the minimum two-day supply of perishable and seven-day supply of non-perishable food stock requirements, cleaning supplies and sharp items were inaccessible to clients in care. Facility had adequate supplies of personal protective equipment in place. Fire extinguishers were observed mounted. For the exterior portion, facility had a patio walkway separating the 2 hallways with outside furniture in good repair; and grounds were free of tripping hazards. Laundry room was kept locked with cleaning supplies kept locked inside the laundry room. Kitchen was in good repair and kept locked only staff are allowed inside the kitchen. LPA Tapia reviewed the COVID 19 mitigation plan and the Emergency Disaster plan of the facility.