Facility Evaluation Report

Licensing Program Analyst (LPA) Jacqueline Shaw Ross made an announced visit to the facility to complete the annual inspection. LPA arrived at the facility and was greeted by Direct Support Provider, Gabriela Gallegos. Administrator, Justine Silverio arrived shortly. LPA toured the inside and outside of the facility.

Currently there are three (3) residents and two (2) staff present at the facility. LPA conducted staff and client interviews. The facility is a three bedroom, two bathroom home. Per the approved fire clearance, the licensee is approved for 4 non-ambulatory residents. All bedrooms are appropriately furnished. The facility is appropriately furnished. The water temperature was tested and measured at 115.5 degrees Fahrenheit. The smoke alarms and carbon monoxide alarms were tested and found operable. LPA observed two fully charged fire extinguishers. The kitchen was observed to be fully stocked with a sufficient amount of food and supplies. Emergency food and water was stored in a storage area in the garage. The knives were stored in a locked drawer in the kitchen. The medications are stored in a locked cabinet in the hallway. P&I funds are kept locked in a cabinet in the garage and are kept separate from facility funds. Chemicals and hazardous items are also stored in a locked cabinet in the garage.

The backyard was observed to be fully fenced with plenty of shade and is free of hazards.

LPA reviewed facility files and records. Background clearances and trainings were observed to be current. Medication was reviewed and appear to be dispensed appropriately according to physician's orders. The facility is completing emergency drills regularly.

During the inspection, no deficiencies were observed. An exit interview was conducted and a copy of this report was reviewed with and provided to the Administrator.