Facility Evaluation Report

Licensing Program Analyst (LPA) Tena Herrera conducted the required annual inspection. LPA arrived unannounced and met with Jeremy Miller (Director) and explained the purpose for today’s visit. The facility is licensed to serve (4) Ambulatory Only Clients Ages 18-59 years. The facility currently has (0) clients.

The facility is a two-story home located in a residential area in Bellflower, Ca. A tour of the facility includes: 1st floor: living room, dining area, kitchen, 1 bedroom, 1 full bath, storage closet, attached garage (with staff office and laundry area), front yard with outdoor activity area. 2nd floor: 3 bedrooms and 2 bathrooms (1 bath is inside master room).

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

Infection Control: Facility has PPE supplies and there's an Infection Control Plan maintained at the facility.

Physical Plant & Environment Safety: LPA toured facility, clients’ bedrooms were checked and closet/drawer space to accommodate each client 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. The hot water temperature was tested in the client bathrooms and were within the required range of 105-120 degrees F. All storage areas for cleaning solutions, toxins, knives, and hazardous items are kept in a locked cabinet in the garage and are inaccessible to clients and a locked kitchen cabinet under sink. Smoke detectors and carbon monoxide detectors are operable and in compliance. There fire extinguishers was observed and is fully charged (one upstairs and one downstairs).

Operational Requirements: Staff have proper training to meet the needs of the clients in care.

Staffing : There appears to be sufficient staffing at all times in the facility. There are currently no clients at the facility, however, upon placement of clients Director Jeremy confirmed there will be staff to meet the needs. (Continued on LIC809-C)