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 Direct Service Personnel (DSP) Staff Carolina Vargas. Administrator (AD) Nicholas Romo was currently out of town during the visit. The facility is licensed for three ambulatory clients. Currently there are three clients living here during today's visit.

LPA Tea reviewed three client files and one staff file. Client files and staff file contained all required documentation. The administrator certificate expires on April 29, 2025.

LPA Tea along with DSP Staff Vargas toured the facility at 1:46 PM. LPA toured the physical plant, checked food service, and the first aid kit. The facility is a one-story home with three client bedrooms, an office room, and three bathrooms. The facility has a kitchen, dining room, and living room, and a small family room, and an attached garage. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms are operational. There are cameras in common areas that record without sound. Client bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each client comfortably. One client bedroom does have a small crack on the wall close to the ceiling due to recent bathroom renovations. Staff will let the administrator know about the crack and will fix it immediately. Client bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, and shower was free of mold/mildew. Water temperature measured around 117.5 Fahrenheit degrees. Client bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards; doorways were free of obstructions. First aid kit had all the required elements including dressings, bandages, tweezers, thermometer, and scissors. Kitchen was inspected. Perishable and non-perishable