Facility Evaluation Report

On 03/22/2022 at 9:20 AM, Licensing Program Analyst (LPA) T. White arrived unannounced to conduct a Post-Licensing inspection. LPA met with Administrator, Robert Hernandez and explained the purpose of today’s inspection. Administrator holds a certificate #6041381735 that expires on 05/26/2022. LPA was allowed entry into the facility that is licensed to serve a total capacity of 4 ambulatory clients, which 2 may be non-ambulatory.

LPA observed 2 clients and 6 staff members present at the facility.

LPA 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. Hot water temperature in the client's shared bathroom measured at 105.8 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. There is a minimum of 7-day supply of nonperishable and 2-day of perishable foods.

Smoke detectors and carbon monoxide were in operating condition during inspection. Fire extinguisher was last serviced on September 10, 2021. First aid kit was observed to be complete. Fire drill was last conducted on 02/28/2022. Emergency Disaster Plan last posted 01/22/2022. LPA observed completed mitigation plan. LPA observed vehicle registration has been updated. LPA reviewed 2 resident files/medications, and 3 staff records. LPA reviewed 1 clients' P & I money. Based on Administrators interview, facility has not received P & I money for 1 client.

Exit interview conducted with Administrator and a copy of report given.