Facility Evaluation Report

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced visit to conduct a Required Annual Inspection. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Caregiver Vilma Lopez. LPA then met with Director Yoanne Crisostomo, who arrived later during the visit.

According to the facility’s license, the facility has a maximum capacity of four (4) clients, of whom all must be ambulatory. Per LPA observation, review of LIC602 Physician’s Reports, and staff interview: During today’s inspection, there were a total of four (4) clients in care, and all were ambulatory. The facility’s license did not include endorsements for delayed egress doors or secured perimeter, and neither of these were present during today’s visit.

LPA, accompanied by Licensee’s staff, toured the interior and exterior of the facility and inspected each room. 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 in working order. Extra linens and hygiene 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 76 F. Hot water temperature at taps accessible to clients were also compliant: Kitchen Sink was 107.6 F and Hallway Bathroom Sink was 107.3 F. The Staff Bathroom sink was 107.4 F. Appliances to preserve perishable food were compliant in temperature: Kitchen Refrigerator was 40 F and Kitchen Freezer was 0 F. There was at least two (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.