Facility Evaluation Report

Licensing Program Analyst (LPA) Marcela Yanez conducted an unannounced Required 1 Year visit and met with Rogeline Jimenez , Designated Administrator. LPA anounnced the purpose of the visit. LPA observed 1 staff and 1 resident. 5 out of 6 residents at day program.

During visit, LPA toured the facility inside and out. LPA toured the garage area and observed food storage areas and locked cabinets for cleaning supplies.

LPA observed the kitchen area and observed locked cabinets for medications, sharp objects, and cleaning supplies. LPA observed refrigerator temperature measured with thermometer at 42 degrees F and freezer at 0 degrees, additional refrigerator in garage.

LPA observed perishable food supply of at least two days and a non-perishable food supply of at least seven days.

LPA toured three resident bedrooms. Each bedroom had available bedding and clothing storage areas as well as functioning lights.

ADM tested the smoke detectors in the hallway found the smoke detector to function properly when tested.

LPA toured two out of two resident bathrooms. Each bathroom had available soap and paper towels and functioning lights. The water temperatures in the bathroom sink measured with thermometer at 107.7 degrees F. Page 1 of 2