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25 | Licensing Program Analyst (LPA) David Roman conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Direct Support Staff, Nancy Gedeis and Priscila Galindo. According to the facility’s license, the facility has a maximum capacity of four clients, of whom two may be non-ambulatory.
LPA along with facility staff toured the interior and exterior of the facility and inspected each room. The facility was sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities.
Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to clients. Medications were labeled, as required, and stored in locked areas. Water temperature was measured at 120 degrees F.
No pools or bodies of water on the premises. Per staff, no firearms or ammunition are kept at the facility. Carbon monoxide/smoke alarms tested at 12:50pm, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present. First aid kit(s) were complete and readily accessible. Resident records reviewed had required documentation. Staff records reviewed and had required documentation.
At a later time Administrator, Silvia Davalos, arrived to the facility to meet with LPA. LPA conducted an exit interview was conducted with Administrator, Silvia Davalos, to whom a copy of this report and the Licensee/Appeal Rights and were provided during the visit. Their signature on this form acknowledges the receipt of this report and their rights.
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