Facility Evaluation Report

Licensing Program Analysts (LPAs) Jenny Olson and Brian Phillips arrived unannounced to conduct a one year required annual. The LPAs met with Licensee/Administrator Helen San Antonio and explained the reason for the visit.

The LPAs toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

Kitchen: The kitchen area was observed at 12:10 p.m. The facility has a sufficient supply of non-perishable and perishable food items. Cleaning supplies and disinfectants are stored under the sink, inaccessible to clients. Knives are stored in a cabinet in the kitchen.

Common areas: Living and dining room furniture were observed to be in good condition. There is a fireplace in the living room, which is screened and inaccessible. At 2:15 p.m., smoke detector(s) and carbon monoxide detector were tested and 4 were operational at the time of the visit. The LPAs observed required postings throughout the common space. The fire extinguisher was charged and serviced 12/20/2022.

The backyard has a covered outdoor area equipped with furniture for client use. No bodies of water noted. The washer and dryer are in the garage. The garage is not locked.

Restrooms: The two client restrooms were clean and sanitary and in operating condition with non-skid surfaces. The bathrooms were sufficiently stocked with soap and paper towels. Around 1:00 p.m., the hot water temperature measured in the client restrooms at 110 degrees Fahrenheit.

Bedrooms: There are three (3) client rooms, which were furnished with appropriate linens and required furniture. A linen closet was located outside of the rooms, which stocked extra linens and towels.

Records: The LPAs reviewed client and staff records at 11:00 a.m. The LPAs reviewed four (4) client files for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, and current needs and services plan. All files were complete. Continued on 809-C