Facility Evaluation Report

Licensing Program Analyst (LPA) Ruth Martinez is conducting this visit for the purpose of conducting a health and safety check. LPA arrived at the facility was greeted and granted entry to the facility by Ernij Lumangkun, direct care staff and explained the nature of the visit.

The facility has two clients in care. Upon entry LPA observed there were two clients in the living room watching television. During the visit LPA took a tour of the inside of the physical plant of the facility. LPA inspected food supply; adequate amount was observed to be within regulations. The facility has a two-day supply of perishables and seven-day supply of non-perishables food available as required by regulations. Facility has two extra refrigerators in the garage with food supply. LPA observed hallways and walkways were free of obstruction. LPA observed a locked storage with client’s medication. LPA reviewed medication and it was observed all medication was labeled and meet regulation requirements. LPA toured the outside of the facility and observed there is a covered patio with shaded seating area for the clients enjoyment.

LPA interviewed staff and reviewed records. LPA reviewed two (2) client records. All the required documentation was present and current in client’s files reviewed. The facility P&I records were reviewed and observed that an individual log is maintained for each client. All monies are accounted for and attached receipts for record keeping. LPA reviewed two (2) employee records and employee has a criminal record clearance and is associated to this location.

This report was reviewed with facility representative and a copy of this report was provided to the facility.