Facility Evaluation Report

Licensing Program Analyst (LPA) Imaculada Vasquez and Yolanda Delgado arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry by Licensee Emelita Price and Staff Rositas Melendros. LPA began inspection with introduction and visit purpose. Upon arrival LPA learned that one (1) client resides at this facility and there is currently two (2) caregiver present. The facility is a single story structure consisting of four (4) bedrooms and two (2) bathrooms. There is not Infection Control Plan on file.

Client Records-Incident Reports/Clients Rights-Information/Dental- LPA began review of client records. One (1) records were reviewed. LPA reviewed for identification and emergency information, admission agreement, medical assessment, and TB test results, needs and service plans - missing, functional assessment, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification.

Personnel Records/Training/and Staffing- LPA began review of employee records- Two (2) records were reviewed. LPA reviewed employee records for first aid certification- missing, criminal record clearance or an exemption, health screening and TB test results, employee rights, training verification, and current administrator certification; expiration date 12/13/2027.

Food Service- Food prep areas are clean and organized. Food supply meets the requirement of one (1) week supply of non-perishable and two (2) day supply of perishables - not observed. Emergency food and water supply was not present. There is a locked location for chemicals and sharps in the kitchen.