Facility Evaluation Report

On the date and noted above Licensing Program Analysts (LPAs) Janira Arreola and Sara Martinez made an unannounced visit at the facility for the purpose of conducting a health and safety check. LPA Arreola met with licensee Manuel Vasquez, and explained the purpose of the visit.

At the time of the visit there was (1) staff and (3) client's present. The facility currently has a census of 2. However due to staffing client# 3 (C3) that is placed at the sister facility, C3 will stay at the facility until 7pm. LPA observed the facility to be within the required ratio of 3:1. LPAs conducted a tour of the facilities interior and exterior. The facility has (4) bedrooms and (2) bathrooms, an activity/lounge area, Living room, kitchen, garage, front yard and backyard. The facility was observed to be clean and free of clutter. Client #1 (C1) was inside their room laying down, and client #2 (C2) was taking a shower, and C3 was in the t.v. room. The facility has (2) rooms that are vacant, and (2) rooms that are occupied.

LPA observed the facility's food supply which met the requirements; 2 day supply of perishable and a 7 day supply of non-perishable food items. LPA observed a sufficient amount of personal protective equipment (PPE) supplies at the facility. LPA observed clients medications and observed at least a 30 day supply. LPA observed a sufficient amount of paper supplies (paper towels and toilet paper), for the amount of clients in care.

No health and safety concerns were observed during the time of the visit.

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