Facility Evaluation Report

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced annual inspection focusing on the Infection Control Domain. LPA Pena was greeted by DSP Danilo Panaligan and discussed the purpose of today's visit. LPA was screened and had temperature checked by the staff upon entry. Shortly thereafter, the Administrator, Flerida Resurreccion arrived and assisted LPA with the inspection. There are currently (3) clients in the facility. The facility is licensed to care for and approved to serve (4) developmentally disabled level 4B clients (1) non-ambulatory and ( 3) ambulatory and is vendorized by Harbor Regional Center. The facility is a single-story ho me located in a residential neighborhood. It consists of (4) client bedrooms, (1) staff room, dining room, kitchen, living room, (2) full bathrooms, backyard with shaded patio furniture, and attached 2-car garage. The emergency disaster drill was conducted on 0 2/03/2023. Administrator certificate will expire on 5/13/2024. LPA reminded Administrator that the annual fee is due on 3/30/2023.

The facility had a universal entrance screening area including a sign-in sheet, thermometer, and hand sanitizer. A temperature check log for staff and clients was maintained daily.

COVID-19 signage was placed in several areas including entrance and common areas.

Staff members wore face masks throughout their shift.

Facility maintained a 30-day supply of PPE located in the garage.

There was a sufficient supply of 2-day perishable foods and 7-day non-perishable foods.

Cleaning solutions and sharps were locked and inaccessible.

The laundry room is located in the locked garage and is clean and has cleaning supplies inaccessible to residents.

Hot water temperature was measured at 10:30am. Kitchen's hot water temperature measured at 109.8 deg F, at 10:35am, bathroom #1 measured at 93.6 deg F , bathroom #2 temperature measured at 111.9 deg F. LPA asked the staff to adjust the hot water temperature and LPA will re-test the hot water temperature in bathroom #1. At 11:55am, the 2nd reading in bathroom #1 measured at 94.6 deg F which was still not within the required 105-120 deg F.

All clients rooms contained required furniture including bed, dresser, night stand, lamp and chair.

Bathrooms have the required grabs bars, non-skid materials and contained hygiene supplies including liquid soap, paper towels, and toilet paper.

Medications were locked and centrally stored in a cabinet. Clients medications were reviewed to confirm medication is given as prescribed and is documented properly.

Smoke detectors/carbon monoxide detectors were present and operable.

Exit door in client bedroom #3 has auditory device that was not operating at the time of the visit.

There are no cameras inside the facility.

Indoor/outdoor passageways were free from obstruction.

A fire extinguisher was observed in the dining area to be fully charged and was last serviced on 4/14/2022.

Client files were inspected, and emergency contact information and health screenings were up to date for all clients.

Staff files were inspected and contained the required health screenings, criminal record clearances, and training.

Pursuant to Title 22, deficiencies were cited on the attached 809D. An exit interview was conducted and a copy of this report and appeal rights were provided to the Administrator, Flerida Resurreccion.