Routine inspection·December 16, 2022

On 12/16/22 at 1:12 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced. LPA was greeted by Administrator Doderlein Anaya Fernandez and allowed entry into the facility. Administrator is live in staff with her husband and minor child. Caregiver and designee administrator S1 was also at the facility. LPA was not pre-screened for COVID. There did not appear to be a designated area for Covid screening. Facility was toured inside and out. The house consists of 6 bedrooms and 2 bathrooms. One bedroom is for live in staff, 2 bedrooms are available for single residents, 2 bedrooms are available for residents to share the rooms. Current census is 1. Resident was present in the facility during the inspection. Resident was in the common area asleep. Current resident resides in a share room with no current roommate. Entry way of the facility was free from any obstructions and had a log in book. LPA observed kitchen as being clean and free of clutter. Facility has 2-days’ worth of perishable items and 7-days’ worth of non-perishable items. Knives were locked and inaccessible to resident. Cleaning products were found under the sink, S1 was doing dishes TA was issued to remind cleaning products are to remain inaccessible to residents at all times. Water temperature read at 106.5 degrees Fahrenheit. LPA observed R1s bedrooms was clean and free of clutter, R1 had adequate storage space for belongings and good lighting in the room. LPA observed the other bedrooms as clean, free from clutter, and readily available for residents. See LIC809C for continuation of this report Bathrooms were observed as being clean and free of clutter. LPA observed fire extinguishers are current with service and in good standing condition. LPA observed smoke alarm in working conditions. All doors leading out of the facility have alarms. Backyard was clean and free from any obstructions blocking the entrance. An exit interview was conducted, and a copy of this report dated 12/16/2022 along with LIC809D. Plan of Correction (POC) were discussed. Appeal Rights was provided to Administrator Doderlein Anaya Fernandez whose signature below confirms receipt of these rights.