Facility Evaluation Report

Licensing Program Analyst (LPA) V. Maldonado made an unannounced required annual inspection at the facility. LPA Maldonado met with administrator Rana Chapkahneh and explained the purpose of the visit. LPA used the infection control tool to evaluate the facility. During today's visit, LPA toured the facility physical plant with the administrator, observed the food supply, reviewed COVID-19 procedures, and client's medications. The facility has submitted a mitigation plan- approved on 08/17/21.

The facility is licensed to have four (4) Developmental disabled clients between the ages of 18-59 years of age, two (2) non-ambulatory with restricted health conditions. The home consists of three (3) client bedrooms, two (2) bathrooms, living room, kitchen, dining area, laundry area, and detached garage. LPA observed all 3 client bedrooms to have the required linens, furniture and sufficient lighting. The facility was at a comfortable 77*F, as observed on the thermostat in the hallway. All entry ways and walkways are free of debris and hazards. The bathrooms were observed to have a working shower, toilet, and wash basin, and were all fully stocked with hand soap and paper towels. The water temperature in bathroom# 1 measured at 128.7*F and measured at 134.7*F in bathroom# 2, which is currently not in compliance with California Code of Regulations- Title 22. Sufficient PPE was observed at the entrance of the facility- readily available to the clients in care, and additional PPE was stored in the garage. The food supply in the facility was observed to have the required two-day non-perishables, seven-day of non-perishables, and emergency food supplies. The laundry room was observed to have working appliances and in good repair. All toxins, cleaning supplies, sharps, and medications, were locked in a cabinet above the laundry appliances, separate from each other. The smoke/carbon monoxide detectors are interconnected, were tested and were observed to be in working conditions. LPA reviewed 3 of 4 client's medications and were observed to have current and accurate Medication Administration Records.