Facility Evaluation Report

Licensing Program Analyst (LPA), Alviso is conducting an Required-1 Year inspection, on 8/13/24 at approximately 9:00am, and met with Administrator Joyce Kamau.

Currently four (4) clients in care. Facility has an approved fire clearance four (6) ambulatory clients. All client rooms are private. The facility will only accept four (4) clients into care, per Licensee/Administrator. The facility has operated with four (4) clients in care for the last several years.

One of the resident rooms is now used as a staff room. Administrator to submit updated facility sketch, and application form LIC200, no later than 8/19/2024. Once the documents are received by Licensing, the LPA will ensure an updated fire clearance is obtained.

The facility does have a required infection control plan. The facility does have a required emergency disaster plan. Facility had an evacuation fire drill on July 16, 2024.

LPA reviewed four (4) client files. Files were complete.

LPA reviewed two (2) staff files. Staff had criminal record clearance as required. Staff had first aid and CPR certification as required. Staff had required training.

Facility had a sufficient food supply. Medications were locked and inaccessible to clients in care. Sufficient cleaners/disinfectants, paper products, hygiene products, and linens. Facility had a sufficient supply of furnishings for client use. Disinfectants/cleaners were locked and inaccessible to clients in care. Facility was clean and orderly. The facility was observed to be at a comfortable temperature. Sufficient lighting in hallways, bathrooms, resident rooms, and common areas. Hot water was checked at 119.2 degrees Fahrenheit, which is within regulation. Administrator understands to monitor the water to help ensure it doesn't go over 120. degrees Fahrenheit.