Facility Evaluation Report

Licensing Program Analyst (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 Administrator Administrator Kinnah Gutierrez later arrived to meet with LPA. According to the facility’s license, the facility has a maximum capacity of four (4) clients, of which all must be ambulatory.

LPA, accompanied by staff, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Client bedrooms contained the required furnishings. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities.

There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to clients. Medications were labeled, as required, and stored in locked areas.

No pools or bodies of water on the premises. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher were present. First aid kit were complete and readily accessible. Required licensing postings were observed in visible areas of the facility.

LPA interviewed staff/clients and reviewed multiple staff and client records/files. The files which LPA reviewed contained required documents. Confidential records were stored in locked areas.

No deficiencie s were observed or cited during today's annual inspection.

An exit interview was conducted with Administrator Gutierrez, to whom a copy of this report was provided during the visit.