Facility Evaluation Report

Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced required 1-year visit to the facility. LPA met with Jennifer Ulloa, facility representative, and discussed the purpose of the visit.

The facility is an Adult Residential, 4i, facility. The facility has a license capacity of (6) ambulatory clients and a current census of (3) clients. During today's inspection, two (2) staff and one client were present at the facility. LPA conducted an overall inspection of the facility, which included, but was not limited to, the following:

Physical Plant: LPA observed indoor and outdoor passageways are kept free of obstructions. The facility has sufficient indoor and outdoor space for client activities. The facility has no bodies of water. The facilities is enclosed with latched gates. The facility is maintained at a comfortable temperature. Client bedrooms were equipped with furniture in good repair, sufficient bed linen and lighting. Client bathroom shower, faucets, and toilet were operating properly. Bathroom hot water temperature tested at 117 degrees F. The facility has sufficient activity supplies for clients and client activities include community outings and day program participation. The facility has sufficient linen, personal hygiene products, and furniture for clients in care. The facility has operating telephone service, fire/carbon monoxide alarms, and laundry equipment. Cleaning supplies, and sharps were kept locked and inaccessible to clients in care.

Food Service: The facility has sufficient non-perishable and perishable food for number of clients in care. The refrigerator and freezer where operating in a healthful manner. The facility has sufficient cups, plates, and utensils for client use.