Facility Evaluation Report

Licensing Program Analyst (LPA) Robert Campbell arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility House Manager - Inocencia Flores and granted entry. LPA began inspection with introduction and visit purpose. Upon arrival LPA learned that five (5) clients live at this facility. There was currently one (1) staff member present. House Manager - Inocencia Flores, conducted the facility tour. There is an Infection Control Plan on file.

Client Records-Incident Reports/Clients Rights-Information/Dental- LPA reviewed five (5) Residents records. 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/and Staffing - LPA reviewed employee records. Five (5) 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.

Denise O’Reilly, Administrator’s license expiration date is 03/21/2027.