Facility Evaluation Report

Licensing Program Analyst (LPA) Dwayne Mason Jr. made an unannounced visit for the purpose of conducting a required annual inspection. LPA was greeted and granted entry into facility by House Manager (HM) Samuel Jones. Administrator (AD) Divina Alipio arrived approximately fifteen minutes after the LPA's arrival.

The facility is a one-story home with four client bedrooms, two client bathrooms, kitchen, dining room, living

room, den, backyard and attached 2-car garage. LPA observed residents to be away at Day Program or exercising/relaxing at the facility. The facility appears clean and sanitary. All client rooms had required elements, including bed, chair, closet space and ample lighting. Facility had extra linens for clients in the hallway closet. Restrooms are stocked with soap and paper towels and have hand washing postings. Hot water measured 109.2 degrees Fahrenheit in the common bathroom and 108.2 degrees Fahrenheit in the bathroom in one of the client rooms. LPA observed facility has emergency food and water supply. LPA observed knives to be locked under the kitchen sink separately from chemicals. LPA observed other hazardous materials like chemicals and cleaners to be locked in a closet. Medication for each resident is kept locked in a cabinet in the den. The backyard has a shaded seating area. Exit gates are unlocked and self latching. LPA observed exit gates to be unobstructed. LPA reviewed four of the four client files. LPA also reviewed three personnel files. LPA also reviewed P&I and Medicaiton for all clients. LPA noted one client does not receive P&I. The facility also has holiday decorations, various games and clients also get to participate in gardening amongst other activities.

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