Facility Evaluation Report

Licensing Program Analyst (LPA) Kelly Dulek conducted a required annual visit and inspection. This annual had a specific emphasis on infection control practices and procedures. The Administrator was unavailable during today's visit. Office staff are designated to sign all reports. Entrance interview conducted.

The LPA, along with facility office staff Jennifer Beltran, beginning at 10:57AM 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:

KITCHEN: The facility is equipped with two separate kitchens designated as Kitchen A and Kitchen B. Both kitchens were equipped with fixtures and appliances that appeared clean and functional. There was an adequate supply of perishable food to accommodate 15 clients for two days and nonperishable food to accommodate 15 clients for one week.

BEDROOMS: There were 15 bedrooms designated for client use. All bedrooms were furnished for single occupancy and were properly furnished and had adequate supplies of bedding and linen. No visible hazards were observed.

BATHROOMS: Each of the 15 bedrooms included an individual half bathroom equipped with a sink and commode. All bathrooms were properly supplied with paper products and personal hygiene items and fixtures were observed to be functional at the time of the visit. There were four shower rooms, two at each end of the facility designated for client use. Water temperature was measured in random rooms throughout.

COMMON AREAS: These included two dining areas, one adjacent to each Kitchen and designated as A