Facility Evaluation Report

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a required annual visit at 08:55AM. This annual had a specific emphasis on infection control practices and procedures. The LPA initially met with staff Lucy Irog and discussed the reason for the visit. Administrator Louisa Mae Espena arrived at the facility at 09:35AM.

The facility is vendored by Tri-Counties Regional Center as a Level III home. At 09:11AM, the LPA, along with facility staff Lucy, toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed:

Fire extinguisher is fully charged and last serviced 06/06/2022. Smoke detectors and carbon monoxide detectors were tested at 09:50AM and were operational at the time of the visit.

KITCHEN : Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food. All knives were observed to be locked in a kitchen drawer.

Garage was observed unlocked, however, the garage contained separate locked cabinets for chemical storage and laundry supplies as well as emergency food/water supply and storage.

COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, living room, dining room, and den furniture was observed to be in good condition. A fireplace was observed and was adequately screened. The LPA observed the required postings in the common area.

BEDROOMS: The LPA observed the client bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are 4 (four) total bedrooms; 3 (three) shared rooms are for client use and 1 (one) is designated as a staff room. Staff room was observed to be locked and empty at the time of the visit.