Facility Evaluation Report

On today’s date, Licensing Program Analyst (LPA) LPA Rosie Quiroz conducted an unannounced visit for the purpose of conducting a required annual inspection. LPA Quiroz was greeted and granted entry into the facility by Live in Direct Care Staff (DCS) Luzma Duco and explained the nature of the visit. Administrator Lori Cook arrived shortly after. This facility is licensed to provide services to 6 Ambulatory Clients. Facility is a level 2 home providing services to clients developmentally disabled ages 18 to 59 years old.

Administrator (AD) Lori Cook has an Administrator Certificate with expiration date of 11/20/2021.

On or about 9:11am LPA Quiroz along with DCS Duco toured the inside and outside of facility. Staff working at facility was observed to be wearing face masks upon arrival to facility. There are four clients in care and there are no active COVID-19 cases. During today's inspection visit, there were no clients present at the facility. Administrator indicated "All clients are at day program. They all return between 1:30pm-5:00pm."

LPA Quiroz observed required department postings in the facility as well as hand washing signs in the restrooms. All restrooms observed to have ample soap/sanitizer and appeared clean. LPA Quiroz inspected clients’ bedrooms and appeared clean and sanitary. All bedrooms observed to have all required components. LPA Quiroz observed a check in station in the main entry of the facility. Facility is taking temperatures daily and documenting results. LPA Quiroz observed the emergency disaster and evacuation plan. Facility has back-up emergency food and water supply as well as PPE supplies. LPA Quiroz toured the outside of the facility and observed seating area with table and chairs for client’s enjoyment in the front porch and back yard area. Facility has completed the LIC 808 Mitigation plan dated 3/1/2021, which was approved on today's date.