Facility Evaluation Report

Licensing Program Analyst (LPA) Alviso arrived to conduct an annual continuation visit, on 4/14/23 at approximately 3:25pm, and met with caregiver Sandra Kruze. The LPA started the annual visit on 3/21/23, and had met with the Administrator, see LIC809. The facility has submitted the required infection control plan.

There are four(4) clients in care at this facility, all are ambulatory. The clients all attend day programs, currently there are two(2)clients in the home. The other two(2) were out in the community. Client files were reviewed and found to be complete.

LPA reviewed staff files. All staff have criminal record clearance as required. Staff have required training. Administrator Lindsey has an Adult Residential Administrator Certificate, #6017082735, expires 5/27/24.

LPA toured the facility, LPA observed that the fire extinguishers, two(2), are tagged and serviced as required, expires 10/13/23. All exits were unobstructed. Smoke detectors and carbon monoxide detectors were found to be operational during the visit. Hot water temperature measured between 110.5 degrees F. which is within regulations.

Facility has a sufficient supply of food for clients' in care. Facility has a sufficient supply of cleaners/disinfectants and paper products. Facility had sufficient lighting, dishware, hygiene products, and furnishings for resident use. LPA observed that the utilities were on, and working properly. during the visit. LPA observed that the common areas were cleaned and organized; LPA observed that the garage space was cleaned and organized.