Facility Evaluation Report

Licensing Program Analyst (LPA) Jessica Cho made an unannounced required annual inspection in this facility focusing primarily on the Infection Control. LPA was greeted and granted entry by Administrator (Admin) Emmylou Cinco. LPA stated the purpose of the visit and completed the Coronavirus 2019 (COVID-19) screening procedure. Upon entry, LPA observed the screening station and the required Department COVID-19 postings by the front entrance.

The facility is a single level structure and licensed for six ambulatory clients. This facility offers a Level 2 service. As of today, LPA observed three clients sitting around the dining table doing puzzles. All clients looked happy and well taken care of.

At 2:25 PM, LPA toured the interior and exterior portions of the facility with the Admin. There were two shared bedrooms and one bedroom was for the live in Admin. Rooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke, carbon monoxide, and auditory exit alarms tested operational. Bathrooms observed to be in good repair; and provided with a grab bar and a non-skid floor mat. Facility had the required hand washing signs posted in all the bathrooms. Hot water measured at 111.7 degrees Fahrenheit in Bathroom #1 which was the designated bathroom for the clients and 106.8 degrees Fahrenheit in Bathroom #2 located in the Administrator's private living quarter. Facility met the minimum two day perishable and seven day non-perishable food stock requirements. Medications, cleaning supplies, and sharp items were inaccessible to the residents in care. The fire extinguisher was charged. For the exterior portion, the facility had patio furniture under ample shading, and grounds were free of tripping hazards. The side gates were self-closing and self-latching. LPA observed the emergency disaster and evacuation plans. Facility had sufficient emergency food and five gallons of water supply. The First Aid Kit had all the required components, and the facility had sufficient PPE supplies in the kitchen drawer.