Facility Evaluation Report

Licensing Program Analysts (LPA) Amy Domingo conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit with House Manager Ambrosio Cacanindin.

According to the facility’s license, the facility has a maximum capacity of six (6) clients, all of which must be ambulatory. During today’s inspection, there were a total of six (6) clients in care, all of which were ambulatory per their latest LIC624 Physician's Reports. All staff LPA encountered were all background checked and associated with the facility. The facility sketch was accurate to the current layout of the facility. This facility does not feature a secured perimeter or delayed egress doors. Required licensing postings were observed in visible areas of the facility.

LPA, accompanied by Direct Care Staff Josselyn Barnes Lemus, 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, hygiene supplies, and Personal Protective Equipment (PPE) 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 comfortable and complaint, at 72 F.

LPAs observed via measurement with a thermometer device that hot water temperature at taps accessible to clients were compliant: Kitchen sink was 112 F and Bathroom #1 sink was 110 F.