Facility Evaluation Report

Licensing Program Analyst (LPA) Sara Martinez conducted an unannounced annual required visit. LPA was granted entry and met with Administrator Zoe Wilson, who was informed of the purpose of the visit. At the time of the visit there was one (1) staff and zero (0) clients present. LPA conducted a tour of the interior and exterior, reviewed facility documents and conducted interviews. LPA observed the following:

Physical plant, floors, windows, and doors were observed to be clean and fixtures and furniture were in good repair and were present. The outdoor area was observed to be free of hazards and contained a shaded seated area for clients. The sharp and dangerous objects were observed to be locked and inaccessible to clients in care. The smoke detector and carbon monoxide was operational, and the hot water temperature was recorded at met department requirements. LPA observed facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. LPA observed the facility met the required 2-day supply of perishable and 7-day supply of non-perishable foods. LPA reviewed three (3) staff files and training. All staff have personal records, criminal record clearance, health screening and current CPR/First Aide Certification. Three (3) client files were reviewed, and possessed all required paperwork including Admissions Agreement, Annual Physician's Report, and current Individual Program Plan (IPP). LPA inspected the P&I for two (2) clients and found no discrepancies. All client medication was centrally stored and locked in a cabinet located in the kitchen. LPA reviewed medications for clients and found all medication listed on the Medication Administration Record (MAR) and all required labeling and signatures were found to be in place. Facility has the emergency and disaster plan. Emergency are located in the garage and the facility contains a first aid kit with all required items. Facility staff conducts quarterly disaster drills and monthly fire drills that meet Department requirements. The facility does not contain any bodies of water on the property. There are no firearms or ammunition stored at the facility. No deficiencies were cited at the time of the visit.

An exit interview was conducted where a copy of this report was provided to Administrator Wilson.