Facility Evaluation Report

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Licensee Ivonne Henderson and Administrator Elizabeth Rivera.

According to the facility’s license, the facility has a maximum capacity of four (4) clients, of whom all must be ambulatory. During today’s visit, the facility census was zero (0), meaning there were no clients currently in care. LPA toured the interior and exterior of the facility and inspected all common areas and bedrooms. LPA interviewed all staff. LPA also reviewed the administrative and training records all personnel.

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 and screens, toilets, and showers were working. Extra linens, hygiene, and Personal Protective Equipment (PPE) supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities.

The facility’s ambient internal temperature was complaint at 68 F. Hot water temperature at taps normally accessible to clients were compliant in temperature: Kitchen Sink was 115.7 F, Bathroom #1 Sink was 116.1 F, Bathroom #2 Sink was 117.3 F, and Bathroom #3 Sink was 117.3 F. Refrigerators and freezers used to preserve perishable food were complaint in temperature. There were at least (2) days of perishable food and at least seven (7) days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present and in good condition.