Facility Evaluation Report

Licensing Program Analyst(LPA) Alviso arrived to the facility to conduct a Required 1-Year visit, on 4/7/23 at approximately 10:50am, and met with DSP Sarah Ramrez. LPA asked staff to contact Lead DSP Jasmine Sampson and notify her that the LPA was at the home to conduct a visit. LPA had planned to continue the Post Licensing visit of 3/16 but instead will complete the now available Required 1-Year inspection.

Facility is fire cleared for four ambulatory clients. The LPA toured the facility with staff Sarah. All rooms were furnished and had sufficient lighting. There was a sufficient supply of food. There was a sufficient supply of hygiene products, cleaners, and paper products. There are three(3) full bathrooms for client use.

The fire extinguisher, one(1), was serviced and tagged as required-dated 3/24/23. The medications were locked and inaccessible to the clients in care. Cleaners/toxins were locked up and inaccessible to clients in care. The smoke alarms (9 checked) were all working properly during the visit. Hot water was checked at 112.6F which is within regulation.

LPA observed that the facility had sanitizer available for use in the facility, and there was a sufficient supply of personal protective equipment(PPE) for staff, and others use as needed.

The LPA reviewed four(4) out of four(4) client files. Client files were found to be complete. LPA observed that client cash resources are not co-mingled and records are maintained as required.