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25 | Licensing Program Analyst Bruce Jacobs a tele-visit and prelicensing inspection with applicant Guadalupe Yepiz for this adult care home application. The facility received a fire insspection clearance on 11/17/21 and awaiting vendorization from the Regional Center. Administrator Certification for Guadalupe Yepiz is # 6040451735 expires 6/1/2022.
LPA conducted an inspection of facility including common areas, resident bathrooms, kitchen, dining room, storage, and outside yard area. Requested capacity is 6 clients to be vendorized for 4 clients The facility is clean and in good repair in areas toured. No hazards were noted in courtyard areas, hallways, doorways, etc. No equipment was stored in public areas. Fixtures and furniture all appear to be in good condition. Cleaning solutions are stored separately from food and are secured. There are no bodies of water on the premises.Smoke alarm was tested and operational. Fire extinguisher were in compliance and were serviced in October 20212, 2020 and facility has carbon monoxide detectors.
Adequate number of bedrooms (4) for capacity requested. Physical plant appears consistent with facility sketch. Facility has supply of bedding and towels. Furniture appears appropriate in bedrooms. There is adequate closet/drawer space available. There are plenty of bathrooms for number of residents. Non-skid surfaces/mats were noted in the shower. Kitchen appears to be clean, well supplied with equipment. Facility has current resident and staff files, has adequate supply of forms. First aid kit was present Laundry equipment present, working telephone, emergency lighting. Water temperature was measured at 109.5 degrees F.
Component III was provided. LPA reviewed Personnel Policies, Abuse Reporting Procedures, In-Service Training and Medications Procedures.
Exit interview conducted and copy of this report was provided to applicant for signature. Report sent to the applications unit as this facility is ready for licensure.. |