Facility Evaluation Report

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. LPA Tea was greeted and granted entry into the facility by Direct Service Personnel (DSP) Marissa Notarte. The Administrator (AD), Anna Mallari arrived shortly to assist with the visit. The facility is licensed for 4 non-ambulatory clients. Currently there are 4 clients living here during today's visit.

At 1:25 PM, LPA Tea reviewed four client files and three staff files. Client files and staff files contained all required documentation. The administrator certificate expires on August 31, 2024, however administrator has complied with all course work and is pending renewal at this time.

LPA Tea along with the DSP Notarte toured the facility at 2:27 PM. LPA toured the physical plant, checked food service, and the first aid kit. The facility is a one story home with four client bedrooms, one staff room, and two bathrooms. The facility has a kitchen, dining room, and living room with an attached garage. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms are operational. Client bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each client comfortably. Client bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, and shower was free of mold/mildew. Water temperature measured between 114.2 F degrees and 115.3 F degrees. Client bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had all the required elements including bandages, tweezers, thermometer, and scissors. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPA observed sharps locked underneath the kitchen sink. LPA also observed toxin substances to be secured and locked and inaccessible to clients in a storage closet in the garage.