Facility Evaluation Report

This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of conducting a Required – 1 Year Inspection. LPA met with Administrator (AD) Jeremias Jabonero and discussed the purpose of the inspection.

LPA reviewed Infection Control requirements. At about 2:15PM, LPA and AD conducted a tour of the inside and outside of the facility, common areas, client rooms, kitchen, and garage and observed the following: Structure: facility is a 4-bedroom, 2-bathroom, one-story house with a detached garage that is being used for storage. There is a back yard with a patio cover for the clients. LPA observed 4 staff and 4 clients present at the facility. Client Bedrooms: the 4 client bedrooms are spacious and will easily accommodate the clients’ furnishings. Furniture for each client bedroom inspected. Staff Bedrooms: there are no staff bedrooms. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested between 110 and 115 degrees F in the 2 client bathrooms. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the med closet. Toxins: observed locked in the cleaning closet. Medication cabinet: observed to be locked. First-Aid Kit and Activity Supplies: observed and available. Facility’s licensing fees are paid. At about 2:45PM, LPA reviewed 4 client files and 4 staff files, interviewed 4 clients and 4 staff, inspected medications for 4 clients, and inspected client money and ledgers for 4 clients.

During the inspection, LPA and AD observed the following: based on observation, 2 clients are living in the master bedroom which is only fire cleared for 1 client. During the inspection, the licensee relocated one of the clients to another free bedroom and LPA confirmed. The licensee stated they will request a new fire clearance to clear the master bedroom for 2 clients.