Facility Evaluation Report

This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of conducting a Required – 1 Year Inspection. LPA met with Staff #1 (S1) Judy Palomar and Staff #2 (S2) Shirley Kniazeff and discussed the purpose of the inspection. Administrator (AD) Maxine Kniazeff appeared via telephone.

LPA reviewed Infection Control requirements. At about 1:00PM, LPA and S1 conducted a tour of the inside and outside of the facility, common areas, client rooms, kitchen, and garage and observed the following: Structure: facility is a 6-bedroom, 3-bathroom, one-story house with an attached garage that is being used for storage. There is a back yard with a patio cover for the clients. LPA observed 2 staff and no clients present at the facility. Per S2, the facility was licensed last year but is not yet operating and has not accepted its first client yet. Client Bedrooms: the 6 client bedrooms are spacious and will easily accommodate the clients’ furnishings. Furniture for each client bedroom inspected. Staff Bedrooms: there are no staff bedrooms. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested at 113.5 degrees F in the west common client bathroom and 114 degrees in the east common client bathroom. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: LPA observed the facility has a 7-day supply of non-perishable food and S2 stated the facility will obtain a 2-day supply of perishables prior to accepting clients. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the kitchen. Toxins: observed locked in the kitchen. Medication cabinet: observed to be locked. First-Aid Kit and Activity Supplies: observed and available. Facility’s licensing fees are paid. At about 2:00PM, as the facility is not yet operating and has no clients or staff, LPA inspected storage areas for client files, staff files, client medications, and client monies and ledgers.