Facility Evaluation Report

On 10-6-21 Licensing Program Analyst (LPA)s Tirzah Hubbard and Christina Valerio arrived unannounced to conduct a Required – 1 Year inspection. LPAs contacted the facility to ask follow up questions in regard to Covid-19. LPAs spoke with the Licensee Jinky Paran to ask follow up questions for Covid-19 symptoms. LPAs proceeded to approach the facility to conduct the Annual after the facility was cleared. All required COVID measures were observed. LPAs observed S1 and Administrator wearing mask upon entry. S1 took the temperature of LPAs and asked Covid-19 screening questions. LPAs were allowed entry into the facility that is licensed to serve a total capacity of 4 clients. LPAs interacted with a random number of residents during this visit. The physical plant was toured inside and outside to ensure the safety of the residents.

All required furniture were observed. LPAs observed residents engaging in activity, wearing a mask and practicing social distancing. LPAs observed the facility conducts fire drills monthly. All bedrooms contained a dresser, bed, and night stand. The flooring of the facility is a good condition. LPAs observed the thermostat temperature inside the facility hallway was measured at 74 *F which is within the required range of 68 degrees F (20 degrees C) and 85 degrees F (30 degrees C), or in areas of extreme heat the maximum shall be 30 degrees F (16.6 degrees C) less than the outside temperature. The hot water was measured at 106 *F which is not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C) as per Title 22 regulations. LPAs observed the centrally stored medications area to be locked and inaccessible to clients. LPAs observed 3 of 3 medications counted properly labeled and stored, matching medication administration records (MAR).