Facility Evaluation Report

Licensing Program Analyst (LPA) Imaculada Vasquez arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by Administrator Ruby Joy Ferrer and granted entry. LPA began inspection with introduction and visit purpose. Upon arrival LPA learned that four (4) residents live at this facility. The Administrator, Ruby Joy Ferrer gave a tour of the single story interior and exterior home.

Client Records/Incident Reports/Clients Rights Information: LPA reviewed client records. Two (2) 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.

Personnel Records/Training/ Staffing/ Administration: LPA reviewed employee records. Two (2) 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. The Administrator’s certificate expiration date was 10/30/2027.

Food Service: Food prep areas are clean and organized. Food supply meets the requirement of one (1) week supply of nonperishable and two (2) day supply of perishables. Emergency food and water supply is present. There is a locked location for sharps in the kitchen.