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 met by Josefina Mendoza, Direct Service Professional II (DSP II) and Amalia Ordoveza, Direct Service Professional II (DSP II) and explained the purpose of the visit. Administrator, Priscillah Houston arrived at 3:00pm and assisted LPA with the inspection. 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 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 in the facility. Bathrooms have the basic items required like, hand soap, toilet paper, 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 four (4) bedridden clients is in place. Certificate of Liability Insurance with James + Gable Insurance Brokers is valid and will expire on 07/01/2023. Administrator stated that the facility has a valid Surety Bond coverage in the amount of $2500 and will send a copy to CCL/LPA on or before 6/09/2023. Administrator will request a copy from the corporate office. Last Fire Drill was conducted on 5/01/2023.

Physical Plant/Environment Safety: The facility is a single storey home located in a residential neighborhood, contains four (4) client bedrooms, two (2) full bathrooms, a family room, a living room, kitchen, dining area, office area, backyard, and attached garage. The facility is licensed to care for Developmentally Disabled Adults, ages 18 through 59, 4 non ambulatory of which (4) may be bedridden. Currently, there are (2) clients living in the facility who are over the age of 59. Age exception letter was approved. All clients residing at this facility receive case management services provided by Harbor Regional Center. Facility level is negotiated. The interior and exterior physical plant was inspected. Client bedrooms were toured. Each bedroom has a smoke detector, bed, linen, dresser, nightstand, light, chair and sufficient closet space. Bathrooms have non-skid materials and contained hygiene supplies including liquid soap, paper towels, and toilet paper. The ceiling in bathroom #2 has water leak damage. The ceiling paint has bubbles and the dry wall was swelling. The Administrator stated that the maintenance person was contacted and scheduled to fix the ceiling next week. Exit doors are free of any obstruction and there are no pools or large bodies of water. The backyard was inspected and has a shaded area with tables and chairs for clients use. There are cameras located outside the home only. Attached garage was inspected and LPA observed sufficient supply of PPEs stored in the garage. Kitchen knives, 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 April 20,2023. 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 113.2 deg. F in bathroom #1, and 116.2 deg. F in bathroom #2.