Facility Evaluation Report

Licensing Program Analyst (LPA) Lydia Martinez made an unannounced visit for the purpose of conducting a Required - 1 Year evaluation, in conjunction with a Case Management visit on today's date. Administrator Michelle Domingo accompanied LPA Martinez on a tour of the interior and exterior of the facility.

LPA Martinez reviewed Infection Control requirements. LPA Martinez reviewed facility telephone; provision of sufficient lighting; exit obstructions, if any; and potential hazards. Facility currently has no non ambulatory clients. Basic hygiene items, linen supply, furnishing cleanliness and state of repair of plumbing fixtures were examined. Knives and toxics were properly secured in the kitchen, storage room, and laundry room. Six client and two staff records were reviewed today. Six clients and two staff were interviewed as well. Administrator Certification for Michelle Domingo expires 10/9/2023. HIV training is up-to-date. All facility staff or other individuals who require Criminal Record Clearances have received them prior to working in the facility. Staff has current First Aid Certification. Reviewed two day supply of perishable and seven day supply of non-perishable foods which was found to be adequate. Sanitation of food service area; menus available for review; and modified diets provided as prescribed. Hot water temperature in client bathrooms was within regulatory requirements. Smoke detectors are hardwired and carbon monoxide detectors are in place and tested by outside agency on a quarterly basis. Fire extinguishers were serviced, mounted, and ready for use. Emergency drills are conducted monthly with the most current emergency evacuation drill conducted on 05/03/2023. Documentation was reviewed. Restricted Health Care Plan Approval for Diabetes is on file. None are currently using insulin injections. The clients P&I records were reviewed, LPA observed that an individual log is maintained for each client. All monies are accounted for and logs were kept to date. There is a shaded area with tables and benches for clients and visitors use.

Based on observations made, no deficiencies were observed at this time in the areas evaluated. Copy of this report will be sent to email on file.