Facility Evaluation Report

On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit for the purpose of conducting required annual. LPA was greeted and granted entry into the facility by Lodessa Quialton, Direct Support Professional (DSP) and explained the reason for the visit. Assistant Administrator Richard Sayat (AD) arrived shortly after.

LPA and DSP conducted a tour of the inside and outside of the facility, common areas, client rooms, kitchen, and garage and observed the following: Structure. This is a one-story home. Facility is a 5-bedroom, 2-bathroom, one-story house with an attached garage that is being used for storage. There is a back yard with a patio cover for the clients. LPA observed 3 staff and 2 clients present at the facility. Client Bedrooms. The 4 client bedrooms are spacious and will easily accommodate the clients’ furnishings. Lamps, chairs, linens, and storage for each client bedroom inspected. Staff Bedrooms . LPA inspected the 1 staff bedroom. Bathrooms . Bathrooms were clean, faucets and toilets were operational. Water temperature : tested between 105 and 112 F degrees. LPA inspected all rooms in the facility. Linens & Hygiene Supplies. New linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu : Reviewed. Food Service . LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. Carbon Monoxide, Smoke Detectors, Fire Extinguisher were observed and tested, including the wired smoke detectors/carbon monoxide detectors. Appliances. Stove burners, microwave, washer, and dryer inspected. Knives : observed locked in the kitchen cabinet. Toxins : observed locked in the garage. Medications are locked in a hallway closet.. First-Aid Kit and Activity Supplies : observed and available.

LPA reviewed 4 client files and 5 staff files, inspected medications for 4 clients, and inspected client money and ledgers for 4 clients.