Facility Evaluation Report

Licensing Program Analyst (LPA) Alyssa Ramirez conducted an unannounced post- licensing visit to the facility today. LPA was greeted by and granted entry by Administrator Rayne Fernandez.

LPA toured the facility with staff in addition to conducting a general overall inspection. 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, screens, toilets, and showers were in working order. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, and meetings.

There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. There were no toxic chemicals/poisons accessible to clients. Medications were labeled and stored in a locked area. No pools or bodies of water on premises. Carbon monoxide detector, fire extinguisher, and facility telephone were present.

LPA reviewed staff and resident files. Files were complete.

An exit interview was conducted with Administrator, to whom copies of this report, and the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit. Their signature on this form acknowledges receipt and a copy of the report was given to Administrator.