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 staff. LPA Tirre met with House Manager Levi Mira and explained the reason for the visit.

During the visit LPA toured the facility with House Manager, Facility is a 4 bedroom and 2 bathroom single story home. There are 4 Clients in care. LPA observed proper covid signage at front entrance of facility. Facility has required Department postings. LPA toured all clients rooms, all rooms where within regulations. All restrooms observed contained soap, toilet paper and paper towels. Restrooms had proper hand washing signs posted. Clients were observed relaxing in living room. LPA observed Administrator certificate expiring 10/25/22.

Facility has supplies of PPE but not 30 days supply, LPA reminded House Manager of Department guidelines. Facility has ample food supply. Facility has charged fire extinguisher. 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 orders are current.

An exit interview was conducted with House Manager and copy of report was left at facility.