Facility Evaluation Report

On 04/05/2022 at 12:55 pm, Licensing Program Analysts (LPAs) T. White and R. Campbell arrived unannounced to conduct a required 1-year Annual inspection. LPAs met with Licensee, Raul Cupino and Administrator, Monica Butay. LPAs explained the purpose of today’s inspection. LPAs were allowed entry into the facility that is licensed to serve a total capacity of 4 ambulatory clients, which 2 maybe non-ambulatory.

LPAs toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature for clients is maintained at 73 degree Fahrenheit. Hot water temperature in client's shared bathroom was measured at 115.3 degree Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. All toilets, hand washing, and bathing are safe, sanitary and in operating condition. There is a minimum of 7-day nonperishables and 2-day perishables foods.

LPAs observed smoke detectors and carbon monoxide was in operating condition during inspection. Fire extinguisher was last serviced on 10/12/2021. First aid kit observed to be complete. LPAs observed completed Mitigation Plan. Fire drill was last conducted on 03/14/2022. LPAs reviewed 4 client files and 3 staff records.

The following forms to be updated and submitted to CCLD by 04/15/2022:

LIC 308 Designation of Administrative Responsibility

No deficiencies cited during inspection. Exit interview conducted with Administrator and a copy of report given.