Facility Evaluation Report

Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced visit for the purpose of conducting a required/ annual visit. LPA was greeted, granted entry into the facility by caregiver Sylvia Barlahan. LPA explained the reason for the visit. Administrator Michael San Diego was called and came down to facility.

During the visit LPA toured the facility with Administrator Michael San Diego. Facility is a Level 4D Adult Residential Facility. Facility is a 4 bedroom,(3 client bedrooms, 1 staff bedroom) and 2 bathrooms single story home. There are 5 Clients in care. At time of visit, 4 clients were away at Day program. LPA observed one client engaged in Day program activities outside in Designated visitor area with Day program staff. Client was well groomed and appeared neat in appearance. LPA observed proper covid signage at front entrance. Facility has a sink upon entry with soap and paper towels. Facility has a sign in, Temperature and sanitization station inside facility entrance. Facility has required Department postings. LPA observed Mitigation Plan and Emergency Disaster plan posted. LPA toured all Clients rooms, all rooms where within regulations. All restrooms observed had a working wash basin, contained soap, hand towels and toilet paper. Facility has hand washing signs posted. Facility has operating smoke detectors, carbon monoxide detector and audible alarms for each sliding door entrance/exit. Facility has 2 fire extinguishers which are fully charged. Facility water Temperature was measured at 104.3 Degrees Fahrenheit. Facility has supply of PPE. Facility has 2 refrigerators and 2 pantry's with ample food supply. LPA observed facility has emergency food and water supply. Facility has a secured location for sharps. 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. 5 out of 5 clients files were reviewed. Clients emergency contact information and Physicians reports are current. LPA observed outside areas of facility and no items obstructed pathways. Facility has designated visitation areas.

No deficiencies noted during todays visit. An exit interview was conducted with Administrator Michael San Diego and a copy of report was left at facility.