According to the facility’s license, the facility has a maximum capacity of four (4) clients, all of one which but one can be non ambulatory. During today’s inspection, there were a total of four (4) clients in care, all of which but one were non ambulatory per their latest LIC624 Physician's Reports. All staff LPA encountered were all background checked and associated with the facility. The facility sketch was accurate to the current layout of the facility. This facility does not feature a secured perimeter or delayed egress doors. Required licensing postings were observed in visible areas of the facility.

LPA, accompanied by Administrator, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were in working order. Extra linens, hygiene supplies, and Personal Protective Equipment (PPE) were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility’s ambient internal temperature was comfortable and complaint, at 70 F.

LPAs observed via measurement with a thermometer device that hot water temperature at taps accessible to clients were compliant: Kitchen sink was 112 F and Bathroom #1 sink was 113 F Bathroom #2 111 F.

[CONTINUED ON LIC 809C]

Refrigerator temperature was 24 F and freezer temperature was -4 F. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. Kitchen appliances were working. Medications were labeled, as required, and stored in locked areas.

Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher was serviced within the last 12 months. First Aid Kits were complete and readily accessible. There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to clients. No pools or bodies of water were observed on the premises. Per the licensee, no firearms or ammunition are kept at the facility.

LPAs interviewed multiple staff and LPAs reviewed multiple staff and client records/files. The interviews did not raise any licensing concerns. LPAs reviewed multiple staff and client records/files. LPA's observed the client and staff files contained the required documents. Confidential records were stored in locked areas. Licensee also presented proof of current/active business liability insurance and surety bond.

No deficiencies were cited during today’s visit.

An exit interview was conducted with Administrator Elizabeth Enriquez. Copies of this report and Licensee Appeal Rights (LIC 9058 03/22) were provided at the conclusion of the visit. Facility representative’s signature on this form acknowledges receipt of the rights and a copy of the report.