Facility Evaluation Report

On 12/06/2023 Licensing Program Analyst (LPA) Brian Phillips arrived at the facility unannounced for an unscheduled visit to conduct a required Annual Facility site inspection visit at the facility above. When the LPA arrived, they were greeted by Direct Support Providers Darlene Swift, Herbert Gillett, Rudolph Belisle, and informed them of the reason for the visit. At the time of the inspection, the administrator was not present, but multiple staff members were available and assisting clients.

The LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. This is an Adult Residential Facility (ARF), with an approved fire clearance capacity of four (4) developmentally disabled adults aged 18-59 years old. The facility fire clearance approves one (1) non-ambulatory client and three (3) ambulatory clients. The facility has five (5) bedrooms, two (2) bathrooms, with kitchen, dining room, living room, and an outside area in the backyard for clients to utilize outdoor activities with shade. Four (4) of the facility bedrooms are for clients, while the fifth bedroom is a staff bedroom. This is a DDS Conservatee facility, and as such Tri-Counties Regional Center (TCRC) was invited to the annual facility site inspection but was unable to attend.

KITCHEN: The LPA inspected the kitchen/food service area and observed that knives/sharp instruments are stored in locked drawers inaccessible to clients. Kitchen appliances were in operable condition and looked clean/in good repair. The LPA observed perishable items in good condition, with proper expiration dates precluding the perishable items from expiring. The facility has a sufficient supply of perishable and non-perishable food, which would last over a week (7 days). Additional perishable food items were maintained in a storage area in the garage of the facility as well as an extra refrigerator and extra freezer located in the garage of the facility. The hot water temperature was measured in the kitchen at an appropriate temperature as per the regulation between 105-120 degrees Fahrenheit. Items that could constitute a danger to clients are kept inaccessible to clients in the kitchen area. The kitchen was clean and sanitary, with covered trashcans and operating ventilation systems. Continued on 809-C