Facility Evaluation Report

On this day Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced visit for the purpose of conducting a required/ annual visit. LPA was greeted and was granted entry into the facility by House Manager. Upon entry LPA's temperature was checked and logged. LPA explained the reason for the visit.

During the visit Administrator David Alipio arrived. LPA toured the facility with Administrator and House Manager , Facility is a 4 bedroom and 4 bathroom single story home. There are 3 Clients in care. LPA observed facility has required Department postings. LPA toured all clients rooms, all rooms where within regulations. All restrooms observed contained working water basin, soap, toilet paper and hand towels. Clients were observed relaxing in bedrooms.

Facility has PPE supply. Facility has 2 refrigerators and pantry's with ample food supply. LPA observed facility has emergency food and water supply. Facility has 1 fire extinguisher which is fully charged. Facility has evacuation plan posted. Facility has a secured location for Client medication and files. Facility has 30 days supply of medications for clients. LPA reviewed Clients files during visit. Clients emergency contact information and physicians reports are current. Facility has designated visitation area.

An exit interview was conducted with House Manager Richard Gapuz and copy of report was left at facility.