Facility Evaluation Report

Licensing Program Analyst (LPA) Kathleen Banrasavong arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry. LPA began inspection with introduction and visit purpose. Upon arrival LPA learned that four (4) clients live at this facility. There was three (3) staff members present. The Administrator, Sandra Hernandez later came to conduct and complete the facility tour.

Client Records/Incident Reports/Clients Rights Information: LPA reviewed client records. Four (4) records were reviewed. LPA reviewed for identification and emergency information, admission agreement, medical assessment, and TB test results, needs and service plans, placement, functional assessment, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. P & I appeared to match the logs.

Personnel Records/Training/ Staffing/ Administration : LPA reviewed employee records. Four (4) records were reviewed. LPA reviewed employee records for first aid certification, criminal record clearance or an exemption, health screening and TB test results, employee rights, training verification, and current administrative organization. Sandra Hernandez’s Administrator’s certificate expiration date is 07/29/2025.