Facility Evaluation Report

Licensing Program Analyst (LPA) Alviso arrived to conduct a Required-1 Year visit, on 07/31/25 at approximately 2:35pm, and met with Licensee/Administrator Jane Frye. There are currently six (6) clients in care.

Fire clearance is approved for six(6) ambulatory. Facility has a required Infection Control Plan. Facility has a required Emergency Disaster Plan. Per file review, last emergency disaster drill was conducted on 7/20/25. Facility has emergency food, water, and other supplies, to meet the "72-hour shelter in place" requirements.

LPA reviewed three (3)staff files. All staff had required criminal record clearance. All staff had required annual training. All staff had current first aid, and CPR certification. All staff files were complete.

LPA reviewed six (6) client files. All client files had all the required documents. Client P&I money is handled by each individual client and/or responsible party; Licensee maintains balance/receipts records for three of the clients.

LPA toured the facility with the Administrator. Hot water was measured at 106.7 degrees Fahrenheit. The facility had a sufficient food supply. The facility had a sufficient supply of hygiene products, paper products, and cleaners/disinfectants, All cleaners/disinfectants were locked up and inaccessible to clients in care. All medications were locked up and inaccessible to clients in care. Fire extinguishers, two(2) were charged as required. Facility smoke alarms are hard wired, and are carbon monoxide detectors as well.. All exits were clear and unobstructed. Backyard has provided shade for clients in care. All pathways in backyard are clear of obstruction. Facility was clean and orderly. Bathrooms were clean, and all had soap dispensers and paper towels for resident use. Facility had sufficient linens and furnishings for use. Food supply was sufficient, with a variety of foods for meals and snacks, including water, juice/drinks for resident in care.

LPA is requesting the following documents to be submitted by 8/31/25:

LIC610-Emergency Disaster Plan (9 pages)- if any updates submit a copy

Infection Control Plan - if any updates submit a copy

LIC400 Handling of Client Cash Resources- must be completed

Exit interview conducted with Licensee/Administrator Jane Frye.