Facility Evaluation Report

Licensing Program Analyst (LPA) Alviso conducted a Required-1 Yeart inspection, on 12/21/23 at approximately 9:50am, and met with Abbie Narciso, Administrator/RN. LPA observed two caregivers/DSPs on duty during the inspection. All four (4) clients were at day program.

Emergency drills are held monthly, a fire drill was held on 12/6/23, and a tornado drill on 12/8/23. Facility is fire cleared for five (5) clients that are non-ambulatory, of which five (5) may be bedridden. Facility has a signal system on all exit doors. The facility has a generator as their 2nd required power source. The generators run a check once every week to ensure they are working properly. The fire extinguishers were serviced and tagged as required. All exits were unobstructed. Smoke alarms are hard wired, home is also fire sprinkled, and have two carbon monoxide detectors. The facility was clean and orderly. The facility was observed to be at a comfortable temperature. All bathrooms have grab bars, and roll in showers. The facility had a sufficient supply of food, hygiene products, cleaners, incontinent supplies, personal protective equipment, and paper supplies. Facility had sufficient furnishings. All common areas, hallways, and resident rooms have sufficient lighting. Hot water was checked at 114.8 degrees Fahrenheit.

LPA requested the following updated documents by 1/21/24.

LIC 400- Affidavit regarding Client Cash Resources

Emergency Disaster Plan- if any changes, submit a copy- if no changes, please sign and date and submit copy (last page)

LIC 400- Affidavit regarding Client Cash Resources