Facility Evaluation Report

At approximately 9:00 AM, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to conduct a required 1-year annual inspection. No one answered the door, LPA contacted Licensee, Espi Sorongon who informed LPA that Bessa Livica, Administrator was at another facility and all clients were away. Administrator arrived to the facility at approximately 9:25 AM. Facility is an Adult Residential Facility For Persons with Special Health Care Needs (ARFPSHN) with four (4) non ambulatory clients in care. LPA was informed that 1 of 4 clients is in the hospital and 3 of 4 clients were at their Day Program.

At approximately 9:30 AM, LPA initiated a tour of the facility with Administrator and observed the following: Facility is a one story home, was a comfortable temperature, and passageways were free from obstructions. Water temperature in clients' bathrooms measured within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens and paper products available to clients. Clients' bedrooms were inspected and observed to have appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. Facility does not have at least two days of perishable food, because, currently, all clients have G-tubes and receive physician prescribed formulas as their sole source of nutrition. Facility does have one week of non-perishable foods, as well as an emergency water supply. LPA observed a supply of incontinent care pads and diapers for each of the clients. Medications were centrally stored and locked. There is a covered patio and seating area in the backyard with outdoor space for activities. LPA observed an activity schedule and a facility computer available for client use. Facility has internet available to clients in care and the phone was tested an operational.

Facility's fire extinguisher was observed charged and was last serviced March 2024. Smoke and Carbon Monoxide detectors were tested and operational during inspection. Facility conducts regular monthly emergency/disaster drills, and the most recent drill was conducted June 2024. LPA observed facility's infection control plan and emergency disaster plan which was last updated April 2021. LPA observed a supply of PPE, emergency supplies, flashlights and a first aid kit. Facility has a two backup generators.