Facility Evaluation Report

On this day Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced visit for the purpose of conducting a required/ annual visit. LPA was greeted and was granted entry into the facility by Caregivers. Upon entry LPA's temperature was checked. LPA explained the reason for the visit.

LPA toured the facility with Caregiver Felix Aguilar, Facility is a 4 bedroom and 2 bathroom (3 client rooms, 1 staff room) single story home. There are 3 Clients in care. LPA observed facility has required Department postings. LPA toured all clients rooms, all rooms where within regulations. All restrooms observed contained working water basin, working toilet, soap, toilet paper and paper towels. Facility has ample supply of clean linens and towels. Clients were observed relaxing in bedrooms.

Facility has PPE supply. Facility has refrigerator and pantry with ample food supply. LPA observed facility has emergency food and water supply. Facility has 1 fire extinguisher which is fully charged. Facility has evacuation plan posted. LPA observed Administrator certificate expiring 9/22/2022. 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. Clients emergency contact information and physicians reports are current. Facility has designated visitation area. Facility has a secured location for hazardous liquids and cleaning supplies.

An exit interview was conducted with Caregiver Aguilar and copy of report was left at facility.