Facility Evaluation Report

On 11/1/22 at 9:30am Licensing Program Analyst (LPA) Maja Jensen and LPA Kesha Lewis arrived at facility unannounced to conduct a required 1 year annual inspection. LPA Jensen met with Licensee Maryann Masaya and explained the purpose of today's visit. Licensee Maryann holds a current Administrator certificate good through 11/24/24.

LPA Jensen toured the facility including but not limited kitchen, dining room, living room, 3 client bedrooms, garage and grounds. The facility is a single story structure with 3 double occupancy rooms for clients and a live in staff bedroom. The facility was observed to be sanitary and free of odor. The facility was equipped with adequate furniture and lighting for the 6 clients. During the course of the visit LPA Jensen engaged with 2 of 2 clients that were present. The remaining 4 clients were at day program.

There is a single main entrance with all required signs posted. A thermometer for COVID screening and sign in logs were observed at the facility entrance. The facility has in excess of a 30 day supply of PPE. The emergency disaster plan was reviewed and found to be in compliance. The facility conducts monthly fire drills which are logged. The fire alarm and carbon monoxide detector was tested and found to be in good working order. The facility was observed to have several first aid kits. The first aid kits were observed to be complete with tweezers, scissors, thermometer and various wound dressings.

Medication was observed to be locked and inaccessible to residents. Toxins and cleaning supplies were observed to be locked and inaccessible to residents. Knives and sharp objects were also observed to be locked and inaccessible to residents in care. The facility maintains an ample supply of linens. The bathrooms were observed to be equipped with grab bars at the shower and toilet. Non-slip mats were available for the bathrooms.