Facility Evaluation Report

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA was screened and met by Martin Carating Direct Service Professional (DSP) and explained the purpose of the visit. Administrator Mellanie AIkman arrived at 3:30pm and assisted LPA with the inspection. At 4:00pm, Michael San Diego, Assistant Administrator arrived and assisted LPA with the visit also. The facility is licensed to care for (5) Developmentally Disabled Adults, ages 18 through 59, (3) ambulatory and (2) non ambulatory only. All clients residing at this facility receive case management services provided by Harbor Regional Center.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. There is a hand washing station by the entrance door and a visitor sign-in station located near the front door. The staff are wearing masks throughout their shift and disposable gloves are used to clean and disinfect the high touched surfaces in the common areas. The facility has submitted a COVID-19 Mitigation Plan and Infection Control Plan. Facility has COVID-19 signage posted throughout the facility. Bathrooms have hand washing signs, soap and paper towels. Staff are adhering to infection control requirements.

Operational Requirements: A current Plan of Operation was reviewed. The Infection Control Plan has been added to the Plan. A fire clearance for five (5) ambulatory clients is in place. Surety Bond (Summa Insurance Services) is in effect and in force with bond amount of $1000. The insurance will expire on 01/20/2026. Last Fire Drill was conducted on 03/04/2023.

Physical Plant/Environment Safety: The facility is a single storey home located in a residential neighborhood, contains four (4) client bedrooms, two (2) staff bedrooms, four (4) full bathrooms, a family room, a living room, kitchen, dining area, office area, backyard, and a detached garage. Currently, there are four (4) clients living in the facility. Facility is Level 4I. The interior and exterior physical plant was inspected. Client bedrooms were toured. Each bedr oom has a smoke detector, bed, linen, dresser, light, chair and sufficient closet space. (3) Client bedrooms do not have a night stand. Bathrooms have non-skid materials and contained hygiene supplies including liquid soap, paper towels, and toilet paper. Exit doors are free of any obstruction and there are no pools or large bodies of water. Backyard was inspected and has a shaded area and sitting area. Detached garage was inspected and LPA observed that the garage is being used as a staff bedroom. There is a single twin bed in the corner of the garage and (2) staff who were sitting on the bed confirmed that they use the garage as bedroom. Kitchen kniv es, sharps objects, cleaning supplies and toxic substances are locked and inaccessible to clients. There are two (2) fire extinguishers observed to be fully charged and both were last serviced on June 6, 2022. Smoke alarms and carbon monoxide were tested and operable. There are no firearms or weapons stored at the facility. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. Hot water supply measured 11.9 deg F in the kitchen, 112.4 in bathroom #1, and 113.1 in bathroom #2.