Facility Evaluation Report

Licensing Program Analyst (LPA) Erik Zaragoza conducted an unannounced Required 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA explained the purpose of the visit to Lisa and Bal Manares who are the Direct Support Professionals who work for the facility and explained the purpose of the visit. Administrator Emmanuel Madrigal arrived shortly thereafter. There are two (2) ambulatory developmentally disabled clients who reside in the home. The facility is vendored through the Harbor Regional Center.

The following 12 (CARE) tool domains were observed and reviewed: Infection Control, Physical Plant/Environment Safety, Operational Requirements, Staffing, Personnel Records/Staff Training, Client Rights/Information, Client Records/Incident Reports, Food Service, Health Related Services, Incident Medical and Dental, Disaster Preparedness, and Emergency Intervention.

· Infection control practices and Personal Protective Equipment (PPEs) were observed. LPA asked the administrator to submit a completed infection control plan to LPA within 7 days.

· The facility is a two-story home located in a residential neighborhood that is licensed for a capacity of four (4) ambulatory developmentally disabled clients between the ages of 18-59. It consists of two (2) shared client bedrooms, a staff room, a guest room, a living room, dining room, a kitchen, a shared client restroom which had a hot water temperature reading measured at 110.6 Degrees F, a laundry room which also contained locked cabinets for the facility’s cleaning materials and chemicals along with the client’s medications, a front and back patio area, and a detached garage which is effectively a store area for the facility.