Facility Evaluation Report

Licensing Program Analyst (LPA) Dwayne Mason Jr. arrived at the facility unannounced for the purpose of

conducting a required annual inspection. LPA was greeted and granted entry into facility by Lead DSP Anicia

Lorenzo. Administrator Linda Punzalan joined the inspection before the exit interview.

The facility is a one-story home with six bedrooms, two and half bathrooms, kitchen, dining room, living room,backyard, patio and attached 2-car garage. Facility appears clean, safe and sanitary. LPA noted three clients were away at day program. The facility has all required elements for the client rooms, however, due to behaviors of clients, three rooms don't have all required elements. LPA confirmed the facility has access to the required elements in case a client wants/needs them. All rooms have a bed, closet space and ample lighting. Facility has extra linens for clients in the hallway closet. Restrooms are stocked with soap and paper towels and have hand washing postings. Hot water measured at 112.3 degrees Fahrenheit, 111.5 degrees Fahrenheit and 113.6 degrees Fahrenheit in the bathrooms. LPA observed facility has emergency food and water supply. LPA observed the fire extinguisher was last serviced in 5/11/23. LPA observed hazardous items such as knives, chemicals and cleaners to be locked up in cabinets in the kitchen and the garage. Knives are locked up separate from toxic chemicals. Medication for each resident is kept locked in a cabinet in the kitchen. The backyard has a shaded sitting/lounging area. Exit gates are unlocked and self latching. LPA observed one exit gate's latch is rusted and some bushes have grown in front of the gate. LPA advised facility to address the rusted latch and the overgrown bush as these could cause potential hazards in an emergency. LPA observed picture frames and other unused items in the backyard. LPA advised facility to remove these items. LPA issued one Technical Assistance regarding the exit gate and the unused items. LPA reviewed three client files, P&I and medication. LPA reviewed three staff files.

No deficiencies were noted during today's inspection. An exit interview was conducted and a copy of this report was provided to the facility.