Facility Evaluation Report

Licensing Program Analyst (LPA) Anthony Tuck arrived to conduct an unannounced annual/random inspection on xx/xx/2021. LPA met with staff Luisa Sarmiento and explained the purpose of the visit. Soledad Ednave is the Administrator and holds certificate #6003412735 that expires on 05/19/2023. LPA met with Back up Administrator Lyn Manugo

This facility is a single story building licensed to serve three (3) non-ambulatory and 2 ambulatory residents at any given time. LPA toured the physical plant including but not limited to two resident bedrooms, two resident bathrooms, garage and backyard area. LPA observed the facility to be free of odor, clean and in good repair. LPA observed sufficient furniture and lighting throughout the facility. There are no bodies of water present.

LPA inspected the facility transport vehicle for seat belt safety.

LPA observed sufficient seven day non-perishable and two day perishable food supplies. Hot water temperature was measured at (106.5) degrees Fahrenheit in resident bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Fire extinguishers and smoke and carbon monoxide detectors are in compliance with fire safety. Fire extinguisher last serviced 02/08/2021. Thermostat observed at (72) degrees Fahrenheit. LPA observed centrally stored medications, toxins and sharp knives kept locked and inaccessible to clients. LPA reviewed staff associations to the facility. First aid kit was checked and is complete.

The following forms need updating and submitted to CCLD by 11/08/2021:

No deficiencies were found during today's inspection. Exit interview held with Lyn Manugo and a copy of report given at the conclusion of the visit.