Facility Evaluation Report

At approximately 8:40 AM, Licensing Program Analyst (LPA) Robert Frank arrived unannounced to conduct a Required 1 Year inspection and was greeted by Administrator Nayley Jimenez. Utulivu Home is Licensed as an Adult Residential Facility - Enhanced Behavioral Supports Home (ARF-EBSH). The facility is a single story ranch house with a large back yard and garden area. There is a new, separate, single room building that serves as a Sensory Room. The newly added Sensory Room building has not been added to the facility drawings and submitted to Community Care Licensing (CCL). A Technical Violation is being issued for the drawings not having been submitted. The facility has an approved fire clearance for three (3) non-ambulatory Clients between the ages of eighteen (18) and fifty-nine (59). Upon arrival, LPA was informed that there were three (3) clients in care. At approximately 8:55 AM, LPA reviewed the Facility's Staff Roster and observed that all staff on-site were background cleared and associated to the facility per regulation.

At approximately 9:45 AM, LPA toured the facility with Administrator Jimenez. All exits were clear and unobstructed. The facility's two (2) fire extinguishers were charged but they did not have last serviced tags attached to them. A Technical Violation is being issued for the extinguishers not having an annual inspection. The facility was sufficiently lighted. LPA inspected three (3) client bedrooms and observed all to have sufficient lighting and furnishings as required per Title 22 Regulations. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for clients. Toxins were observed to be stored inaccessible to clients. Facility has an infection control plan as required. The facility has a required emergency disaster plan.