Facility Evaluation Report

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Administrator Chaztiney Cloud, and discussed the purpose of the visit. The facility is an Adult Residential facility with a license capacity of (4) and a current census (4). The facility is a certified Inland Regional Center (IRC) vendor. LPA conducted an overall inspection, which included, but was not limited to, the following:

Operation/Physical Plant: Indoor and outdoor passageways were kept free of obstruction. The facility has no swimming pools or similar bodies of water. The facility has sufficient indoor and outdoor activity space for clients in care. The facility is equipped with smoke/carbon monoxide alarms, laundry equipment, telephone service, emergency food and water. Client bedrooms were equipped with beds, bed linen, nightstands, chairs, and lighting. Client bathrooms were operating in safe conditions. The hot water in client bathrooms tested at degrees 105 degrees F. The facility has locked cabinets were Sharps, cleaning supplies and client medications are kept. The facility has posted: Community Care Licensing complaint poster, emergency telephone numbers, client personal rights, disaster plan, evacuation sketch, activities, food menu and facility license.

Food Service: The facility’s dining and kitchen areas were maintained clean. The facility has sufficient non-perishable and perishable food for number of clients in care.

Health Related Services: The facility maintains record of clients medications and first aid kits with manual.

Personnel/Client Records: Four (4) staff records were reviewed for health screenings, criminal record clearances, orientations, job training, crisis prevention and first aid/CPR certifications. Four (4) client records were reviewed for admission agreements, medical assessments, needs and service plans, and personal/incidental logs (P&I).

No citations were issued. An exit interview was conducted where this report was discussed and a copy provided to Administrator Cloud at the conclusion of the visit.