Facility Evaluation Report

Licensing Program Analyst (LPA) Nancy Guillen is conducting this unannounced visit for the purpose of completing an annual required inspection. LPA was greeted and granted entry into the facility by Bienvenida Shover after explaining the reason for the visit. Administrator (AD) Augusto Masinsin was notified via telephone and later arrived to assist with the inspection. LPA observed Administrator certificate is pending renewal with an expiration date of October 14, 2027. This is an Adult Residential Facility licensed for four ambulatory clients with four clients currently residing at the facility. LPA observed four clients present at the facility at the time of visit.

LPA began the tour of the inside and outside of the facility and observed the following:

This is a one story facility with four client bedrooms, two bathrooms, a living room, family room, kitchen, dining, nook, laundry room, covered patio, and an attached garage with an exterior entry. LPA observed required department postings posted on the wall in the family room. There is a minimum of one week of non-perishables foods and two days of perishables foods available. There is additional food storage in the garage. LPA observed knives and sharps to be stored underneath the kitchen sink. Gas stove, washer, and dryer were all inspected and observed to be operable. The facility is maintained at a comfortable temperature. LPA observed that medication is centrally stored in a locked storage cabinet located in the kitchen. LPA reviewed medication and observed medication was labeled and stored inaccessible to clients in care.