Facility Evaluation Report

Licensing Program Analyst (LPA) Andrea Mendivil conducted an unannounced visit for the purpose of conducting a required annual visit. LPA was greeted and granted entry into facility by Caregiver Milargros Muan. Administrator/Licensee Maria Mendoza arrived at 9:30 AM.

At 9:20 AM, LPA toured facility with Caregiver Milagros Muan. Facility has 1 client present during today’s visit. Facility is a 4 bedroom, 2 bathroom, single story home with a detached garage. LPA observed a screening and sanitizing station at entrance of the facility. LPA observed client relaxing in the backyard of the facility. Facility appears clean and sanitary. All clients rooms had required elements, including bed, chair, closet space and ample lighting. Restrooms are stocked with soap and paper towels and have hand washing postings. Facility has 2 refrigerators with 7 day non perishables and 2 day perishables. LPA observed facility has emergency food and water supply. Facility has a secured location for client medication and files. LPA toured the outside grounds and observed outside visitation area. Exit gates are unlocked and self latching. Facility has a plan for covid testing client staff as needed as well as a plan for isolation. LPA observed a 4 weeks supply of PPE. LPA reviewed all clients files and all contained required documentation including updated emergency information. All staff and clients are fully vaccinated for Covid 19.

No deficiencies noted during today's visit. An exit interview was conducted and a copy of this report was left at the facility.