Facility Evaluation Report

Licensing Program Analyst (LPA) Tena Herrera conducted the required annual inspection. LPA arrived unannounced and met with Assistant Administrator Daniela Duarte and explained the purpose for today’s visit. The facility is licensed to serve (6) non-ambulatory individuals ages 60 and over (1) of which may be bedridden in Room #1. There is a hospice waiver for (2).

The facility is a single-story home located in Bellflower, Ca. A tour of the facility includes: living room, dining area, kitchen, 3 bedrooms, 1 1/2 bathrooms (1/2 bath is designated for staff), laundry area is in the outdoor patio, there is a front yard and back yard. There is a separate detached ADU in the back of the facility that is currently occupied by licensee, this ADU is not part of the licensed facility.

LPA used the Compliance and Regulatory Enforcement (CARE) tools for the visit todays visit and observed the following:

Infection Control: The facility maintains the required Infection Control Plan.

Operational Requirements: The facility has an approved fire clearance, there is a plan of operation with required Infection Control Plan and f acility maintains the required liability insurance .

Physical Plant & Environment Safety: LPA toured facility, residents’ bedrooms were checked and closet/drawer space to accommodate each resident comfortably was available. The front yard is free of debris/hazards and the outdoor and passageways are free of obstruction. No bodies of water were observed at the facility. There are no security bars or weapons on the premises. Hygiene products are readily available for clients. All storage areas for cleaning solutions, toxins, knives, and hazardous items are kept in a locked and are inaccessible to residents. Smoke detectors and carbon monoxide detectors are operable and in compliance. There fire extinguisher was observed and is fully charged.