Facility Evaluation Report

Licensing Program Analyst (LPA) Tricia Danielson arrived unannounced to the facility to conduct a case management visit in conjunction with complaint 18-AS-20220330124618 to check on the health, safety, and welfare of clients in care. LPA met with Licensee/Administrator Manuel Vasquez and explained the purpose of the visit.

One(1) client was present during visit. There was one(1) staff present at the facility to provide care. LPA toured the facility during today's visit. LPA observed all facility utilities to be on and operating without issue. LPA assessed the available food supply and observed that the supply exceeds the requirement of a two(2) day supply of perishable foods and a seven(7) day supply of non-perishable foods. Medications were found to be in sufficient supply as well. The facility was free from obstructions and/or hazards.

Based on the information obtained during today's visit, there are no immediate threats to the health, safety, and welfare of the clients in care.

Also during today's visit, LPA served Vasquez with an immediate exclusion letter for staff Fernando Perez. LPA informed Vasquez that the Department has determined that the presence of Fernando Perez in a facility licensed by the Department of Social Services constitutes a threat to the safety to residents in care, the Department therefore orders the facility to remove Fernando Perez. LPA did not observed Perez at the facility during today's visit. Vasquez reported Perez was terminated November 18, 2022. LPA informed Vasquez that Mr. Perez had been excluded from being employed in any facility licensed by the Department of Social Services and was not permitted to return to the facility. Vasquez stated he understood the conditions of Fernando Perez's exclusion and would not permit Perez to return to the facility.

An exit interview was conducted and a copy of this report was provided to Vasquez.