Facility Evaluation Report

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. LPA Tea was greeted and granted entry into the facility by DSP Staff, Nilda Bognot and explained the reason for the visit. Administrator (AD) Enrique Manabat arrived shortly to assist with the visit. The facility is licensed for four ambulatory clients. Currently there are four clients.

LPA Tea reviewed four client files and two staff files. There were discrepancies noted in the review of resident and staff files. Administrator certificate is pending renewal but has completed and complied with all course work for the administrator certificate.

LPA Tea and AD Manabat toured the facility at around 2:54 PM. LPA toured the physical plant, checked food service, and the first aid kit. The home consists of four client bedrooms, one staff room, three bathrooms, living room, dining room, staff office area, recreational activity area, kitchen and an attached garage. LPA observed smoke detectors/carbon monoxide in client bedrooms, and they are operational. There are cameras with no audio recording in the common area for security purposes. Client bedrooms had the required furniture, and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 105.4 degrees F to 107.7 degrees F. Client bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Doorways were free of obstructions. First aid kit had all the required elements including dressing, bandages, tweezers, thermometer, and scissors. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPA Tea observed sharps locked and secured in a drawer. Toxins were secured underneath the kitchen sink and a shed in the backyard. The fire extinguisher in the living room was fully charged. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there is ample seating in the backyard. LPA observed emergency food and water supply in a cabinet in the dining room area. The staff provides activities like recreational exercises and small outings. They also have backyard BBQs for the clients to enjoy.