Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced case management visit and met with Administrator (ADM) Remedios Ssingson.

LPA observed 2 residents and 4 staff in the facility. During the vest, resident R1 went to day program.

LP toured the closed patio of the facility with ADM. The two exit doors of the closed patio are the only two exits of the facility to backyard. LPA observed the two exit doors of the closed patio were unlocked and are able to open.

ADM stated the facility does not lock the two exit doors of the closed patio.

ADM discussed the action plan with LPA regarding resident R1.

1. The facility follows R1's behavior plan provided by R1's psychologist.

2. The facility staff provide close supervision on R1

3. The facility staff will follow R1 when R1 goes to the backyard to monitor R1.

4. The facility staff encourage R1 to use restroom instead to urine at the backyard.

5. Facility staff encourage R1 to use trash cans to throw cigarette butts.

6. Facility staff will clean backyard frequently.

ADM confirmed the facility received the letter of rescinded waiver request of temporarily closure of the exit doors of the closed patio.

Exit interview was conducted with ADM. the report was provided to ADM for review and signature.