Facility Evaluation Report

Licensing Program Analyst (LPA) Patricia Velazquez conducted an unannounced visit to Pierce Adult Residential Care Home. The purpose of today's visit was to conduct a Required 1 Year inspection. LPA Velazquez was allowed entry into the facility and met with Direct Support Professional (DSP) Jaime Tan. Lead DSP Gino Manaloto arrived later to assist with the visit. The facility is licensed for 4 ambulatory and 2 non-ambulatory clients. There are currently 6 clients living in the facility. DSP Manaloto did not know the date when the last emergency disaster drill was conducted at the facility.

At 2:06 PM LPA Velazquez conducted a tour of the physical plant along with DSP Manaloto. The 1 story home consists of 4 client bedrooms and 1 bathroom. There are 2 staff bedrooms with 1 staff bathroom. The facility also has a living room, dining area, and kitchen. The 6 clients present in the facility appeared well-groomed and well cared-for. The client bedrooms had the required furnishings, bed linens, and closet/drawer space to accommodate each client comfortably. Client bathroom was checked. Client bath towels and personal hygiene supplies were adequately stocked. Toilets and water faucets worked properly, grab bars were secure, showers were free of mold/mildew and a non-skid surface or mat was in place. LPA Velazquez and DSP Manaloto observed the surface of the bathtub had black stains. LPA Velazquez tested the hot water temperature in the client bathroom and the temperature measured at 102.9 degrees Fahrenheit.

LPA Velazquez inspected the kitchen along with DSP Manaloto. Perishable and non-perishable food supply was checked and adequately stocked at the time of the visit but LPA and DSP observed the facility did not have fresh fruit present. DSP Manaloto could not provide copies of dated menus as served as requested by LPA Velazquez. The fire extinguishers were fully charged. The smoke and carbon monoxide detectors were tested and found to be operational. Medications, toxins and sharps were locked and inaccessible to clients.