Facility Evaluation Report

Licensing Program Analyst (LPA) Dawn Segura conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA identified herself and was granted entry by Luis Gutierrez, to whom she disclosed the purpose of the visit.

According to the facility’s license, the facility has a maximum capacity of four (4) clients, of which all must be ambulatory. During today’s inspection, there were a total of two (2) clients in care, of which both were ambulatory. The facility does not feature a secured perimeter or delayed egress doors.

LPA, accompanied by licensee, toured the interior and exterior of the facility, and inspected the rooms. The facility was clean and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, toilet, and shower were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility’s internal temperature and refrigerator and freezer temperatures were within regulatory range.

During today’s visit, LPA observed, via measurement with a thermometer, that hot water temperature at bathroom faucet accessible to clients was out of regulatory range. Water temperature in bathroom which was used by clients initially reached 130 degrees Fahrenheit (F). (Per regulation, hot water at taps accessible to clients is required to be between 105 degrees F and 120 degrees F). Hot water heater was adjusted during the visit, and the water temperature subsequently measured at 126.5 degrees F when measured prior to the end of the visit.

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 sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to clients. Medications were labeled, as