Facility Evaluation Report

Licensing Program Analyst (LPA) Emily Peraldi arrived at the facility unannounced to conduct a required annual visit. At 10:15 a.m., the LPA called one of the Administrators, Charles Carino and explained the reason for the visit. At 10:20 a.m., Administrator Charles Carino arrived at the facility. During the time of the visit, the Licensee, Richard Carino arrived at the facility. The facility is vendored by Tri-Counties Regional Center as a level 4-I home.

RECORD REVIEW: Between 10:45 a.m. and 12:50 p.m., the LPA conducted a file review for all five (5)

clients and staff regularly scheduled and observed the following: Staff have current first aid. Client records were reviewed for, but not limited to current Individual Programming Plan (IPP), medical records, P & I funds, admissions agreement, and consent forms. All files were in order.

Starting 12:55 p.m., the LPA conducted a review of medication and medication documentation with the Administrator for three (3) clients and observed that medications were properly documented and assisted as prescribed.

Starting at 1:09 p.m., the LPA, along with the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards.

KITCHEN: The LPA observed the kitchen and dining area. Kitchen appliances are in operable condition. The facility has a sufficient supply of perishable and non-perishable food. At 1:09 p.m., hot water temperature measured at 106.7-degree Fahrenheit. Knives are stored in a locked kitchen drawer. Medications and first aid are located inside a locked kitchen cabinet. Continued on LIC 809-C.