Facility Evaluation Report

Licensing Program Analyst (LPA) Tena Herrera conducted the required unannounced annual inspection. Upon arrival at 12:09pm there was no one at the facility, LPA attempted to call House Manager Rana there was no answer, LPA returned at 1:30pm and met with Angel Espericueta (Caregiver) and explained the reason for the visit. The facility is licensed to serve (4) Adults ages 18 through 59, (2) of which may be non-ambulatory. Facility currently has 3 clients serviced by Harbor Regional Center.

The facility is a single-story home located in a residential area in Bellflower, Ca. A tour of the facility includes: living room, dining area, kitchen, staff office, 3 client bedrooms, 2 bathrooms, laundry area, detached garage, front yard and back yard.

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

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

Physical Plant & Environment Safety: LPA toured facility, clients’ bedrooms were checked and closet/drawer space to accommodate each client comfortably was available. The backyard 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 was 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. Smoke detectors and carbon monoxide detectors are operable and in compliance. There fire extinguisher was observed and is fully charged.

Operational Requirements: Facility has an activity area furnished for outdoor use.

Staffing : There appears to be sufficient staffing at all times in the facility.