Facility Evaluation Report

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Required Annual Inspection. The LPA introduced himself to Licensee Alexandra Calderon and disclosed the purpose of the visit. The facility was licensed for a capacity of four (4) clients, who may be non-ambulatory downstairs only. All clients were in day program at the time of the visit.

The LPA, accompanied by the licensee, toured the facility, and inspected each client bedroom. The facility

was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms

contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens

and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and

equipment to facilitate dining, laundry, visitation, meetings, and client activities.

There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored.

Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to clients.

Medications were labeled and stored in a locked area of the facility.

No pools, nor bodies of water were observed on the premises. Per staff, no firearms, nor ammunition were kept at the facility. A carbon monoxide detectors, emergency lighting, and facility telephone were all working.

The LPA interviewed staff and reviewed multiple staff and client records. The LPA provided technical advised regarding maintaining personnel records, emergency drill documentation, and maintaining the facility's disaster plan.

An exit interview was conducted with licensee Calderon, to whom a copy of this report and the Licensee/Appeal Rights