Facility Evaluation Report

Licensing Program Analyst (LPA) Dang Nguyen made an unannounced visit to conduct a Required Annual Inspection. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Facilities Manager Mo Bossman. LPA also met with Operations Coordinator Daniel Egli, who arrived shortly after.

According to the facility’s license, the facility has a maximum capacity of six (6) clients, of whom all must be ambulatory. Per LPA observation, LIC602 Physician’s Reports, and staff interviews: During today’s inspection, there were a total of three (3) clients in care, and all were ambulatory. LPA observed the clients in care and interviewed multiple staff. LPA reviewed care files for all clients and the personnel records for multiple active staff.

LPA, accompanied by Licensee’s staff, also toured the interior and exterior of the facility, and inspected all common areas and client bedrooms. 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 69 F. Where tested, hot water temperature at taps normally used by clients for grooming were compliant in temperature: Bathroom #1 Sink was 105.3 F, Bathroom #2 Sink was 113.7 F, and Bathroom #3 Sink was 120 F. Refrigerators and freezers used to preserve perishable food and medication were complaint in temperature. [CONTINUED ON LIC 809-C]