Facility Evaluation Report

Licensing Program Analyst (LPA) Marcella Tarin conducted an unannounced annual inspection and met with Staff S1 Teresita Deausen. LPA stated the purpose of the visit. S1 stated she would call the Administrator (ADM) Jose Roberto Barba to inform him of the visit. S1 stated the facility has 5 clients. LPA observed 4 clients and 3 staff. S1 stated one client was still at day program. ADM arrived at approximately 3PM.

LPA reviewed 2 client records, to include but not limited to physician's reports, care plans, and emergency contact information.

LPA reviewed 2 staff records, to include but not limited to fingerprint background clearance, personnel record, and first aid/cpr training.

LPA toured the interior and exterior of the facility with ADM to include the kitchen, client rooms, dining room, bathrooms, back and front of the facility. All exit and passageways were free and clear of obstruction.

LPA toured the kitchen area and observed a perishable food supply of at least two days and a non-perishable food supply of at least seven days. LPA observed refrigerator temperature display at 37 F and Freezer at -2 F.

Due to time constraints, this annual will be continued at a later date.