Facility Evaluation Report

Licensing Program Analysts (LPAs) Claudia Gutierrez and Dwayne Mason made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPAs were greeted and granted entry by Staff Armand Medalla. Staff Wilfredo Pinales was also present. LPA discussed the purpose of the inspection and Administrator (AD) Anna Tomilloso was contacted by phone and arrived at 10:00 a.m.

During the inspection LPAs and Staff Medalla conducted a tour of the inside and outside of the facility, common areas, client rooms, kitchen, garage and observed the following:

This is a single-story house with six client bedrooms, three bathrooms, and one staff bedroom. Client bedrooms had the required furnishings. LPAs observed all client beds had linens and blankets. LPAs observed two windows were not screened; a Technical Advisory was given on this date. The back yard has a shaded sitting area. LPAs observed two staff and three clients present. Two out of three bathrooms were observed to be free of debris and mildew; a Deficiency was cited on this date, faucets and toilets were operational. Water temperature tested at 115.7 F degrees.

LPA Gutierrez observed emergency disaster plan and emergency phone numbers listed and posted in kitchen of the facility. Food menu was also posted and visible. LPAs observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Smoke detectors and carbon monoxide detectors tested operational. Fire extinguisher was observed to be fully charged. LPA Gutierrez reviewed facility fire drill log that indicate the last fire drill was on 3/19/23. Stove burners, microwave, washer, and dryer were all inspected; a Deficiency was cited on this date. Sharps were observed locked in kitchen drawer. All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to clients. Medication cabinet was observed to be locked and lock is operational. One refrigerated medication was observed to be accessible; a Deficiency was cited on this date. LPAs reviewed three client files and two staff files. LPAs interviewed two clients and two staff. (Cont. LIC809-C)