Facility Evaluation Report

Licensing Program Analyst's (LPA's) Jenifer Tirre and Andrea Mendivil conducted an unannounced visit for the purpose of conducting a required annual visit. LPA's were greeted, granted entry into the facility and temperature was checked by Staff and explained the reason for the visit.

During the visit LPA's toured the facility with Caregiver Warren Quizon and Licensee Cora Gonzales. Facility is a 4 bedroom,(3 client bedrooms 1 staff bedroom) and 2 bathrooms single story home. There are 6 Clients in care. LPA's observed proper covid signage at front entrance of facility as well as a sink upon entry with a sanitization station. Facility has required Department postings. LPA's toured all Clients rooms, all rooms where within regulations. All restrooms observed contained soap, toilet paper, paper towels and working water basin. Clients were observed relaxing in the Living room and bedrooms watching TV. Facility has 1 fire extinguisher which is fully charged. Facility water Temperature was measured between 111.0 and 114.6 Degrees Fahrenheit. Facility has supply of PPE. Facility has refrigerator and pantry with ample food supply. LPA's observed facility has emergency food and water supply. Facility has Mitigation 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 areas.

An exit interview was conducted and copy of report was left at facility.