Facility Evaluation Report

Licensing Program Analyst (LPA) Celine De Perio conducted an unannounced required post-licensing inspection focusing primarily on the Infection Control. LPA De Perio explained reason for visit and was greeted and granted entry by staff on duty who checked temperature prior to entering facility. During the visit, 2 staff were on duty, who contacted facility administrator (AD) Yesenia Menjivar about visit. AD Menjivar was unable to be present during time of visit due to taking a client to a medical appointment, however, provided consent for staff on duty (S1) Lina Raymundo to receive and sign report. As of 12/12/22, there is 1 active COVID-19 case in the facility as verified. LPA De Perio observed the COVID-19 precautionary signs posted throughout the facility. LPA observed the Administrator's Certificate for Yesenia Menjivar, which expires on 10/22/24.

LPA De Perio toured the interior and exterior portions of the facility with S1. The facility is a single level structure and is licensed for 6 ambulatory clients ages 18 through 59. Currently, there are a total of 4 clients in care, of which 2 were only present during today's visit. The two clients who were not at the facility were at a job, and the other was attending a medical appointment. Facility is a level 2 facility. There are a total of 5 bedrooms, of which 4 are private client rooms, and 1 for live in staff. All bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards.

Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. The restrooms were observed to be in good repair, toilets were operational. Water temperature in restrooms were measured at 107.8 degrees Fahrenheit and hand washing signs were also posted in each restroom.

Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to clients in care and located in a locked kitchen drawer. Fire extinguisher was charged, mounted and located in the kitchen corner. LPA De Perio observed the emergency disaster and evacuation plan, which is posted in the kitchen. Facility had back-up emergency food and water supply, located in the kitchen and in the garage.