Facility Evaluation Report

Licensing Program Analyst (LPA) Angel Ascencio conducted an unannounced required annual visit

to the above facility. LPA Ascencio met with the staff Elvia Lemus and explained the reason

for the visit. Licensee Floro Cortes was not able to join LPA but authorized staff Lemus to sign documents. This home is vendor through Tri-Counties Regional Center. This annual had a specific emphasis on infection control practices and procedures. At 1:15 p.m., the LPA, along with staff member toured the physical plant areas inside and outside to ensure there are no health and safety hazards.

BEDROOMS : All client rooms are set up with beds, night stands, lamps, chests of drawers,

chairs and closet space. The beds are furnished with box springs, comfortable mattress and clean

linen; which includes, a mattress pad, top and bottom linens, pillowcases, blanket (if needed) and a

bedspread. Lighting in the rooms appeared adequate. The bedrooms were large enough to allow for

easy passage between the beds. In addition, no bedroom was used as a passageway to another

room, bath or toilet. There are four (4) total bedrooms – two (2) are shared client rooms , and 2 are staff rooms.

RESTROOMS : There are 2 total bathrooms at the h ome for client use. The client bathrooms have a shower with non-skid materials. The toilet and showers have grab bars. Hot water temperature was tested throughout the home and was within normal ranges between 105.0 F and 120.0 F.

COMMON SPACES : In the common areas, walls and flooring were checked for cleanliness and

good condition. At the time of the visit, common seating area and dining room furniture was

observed to be in good condition. Chairs were observed to be at least 6 (six) feet apart for social