Facility Evaluation Report

On 5/11/23, Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced, required annual inspection to the facility. LPA met with Dominador Bartolata, Direct Staff Provider (DSP) and discussed the purpose of the visit. The facility is an Adult Residential Facility licensed for four (4) ambulatory clients. At the time of the visit, two (2) clients and two (2) staff were present at the facility . LPA conduct a general overall inspection, which included, but was not limited to, the following:

Physical Plant: LPA observed no obstructions to indoor and outdoor passageways. Outside gates are self-latching. LPA observed a hot tub which is kept covered, locked and inaccessible to clients in care. Facility is clean and free from odors. The facility is maintained at a comfortable temperature of 69 degrees F. Facility equipped with sufficient lighting. Client bedrooms are equipped with mattresses, nightstands, storage space, sufficient lighting. Bathrooms were clean, equipped with hand rails, appliances were operating appropriately. LPA observed furniture is in good repair and sufficient for clients in care. The hot water temperature tested within regulation at 112 degrees F. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept locked and inaccessible to clients in care. There was a designated storage space for client/staff/facility files. Medications are locked and inaccessible to clients in care.

Food Service: Non-perishable and perishable food supply is sufficient for number of clients in care. Facility has a monthly menu with a variety of food available for clients.

Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department.