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 Flerida Resurreccion, Administrator and explained the purpose of the visit. The facility is licensed to care for (4) Developmentally Disabled Adults, ages 18 through 59, ambulatory only. All clients residing at this facility receive case management services provided by Harbor Regional Center.

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. Staff screened LPA upon entry. Facility has COVID-19 signage posted throughout the facility. Bathrooms have hand washing signs, soap and paper towels. Staff are adhering to infection control requirements. The Infection Control Plan did not list the name of the Infection Preventionist at the facility.

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) ambulatory clients is in place. Surety Bond (Summa Insurance Services) is in effect and in force with bond amount of $2000. The insurance will expire on 01/11/2026. Last Fire Drill was conducted on 03/03/2023.

Physical Plant/Environment Safety: The facility is a single storey home located in a residential neighborhood, contains four (4) client bedrooms, one (1) staff bedroom, two (2) full bathrooms, a family room, a living room, kitchen, dining area, office area, backyard with a swimming pool and detached garage. Currently, there are four (4) clients living in the facility. Facility is Level 4A. The interior and exterior physical plant was inspected. Client bedrooms were toured. Each bedroom has a smoke detector, bed, linen, dresser, night stand, light, chair and sufficient closet space. Bathrooms have non-skid materials and contained hygiene supplies including liquid soap, paper towels, and toilet paper. LPA observed mold and mildew on the walls and ceiling of the shower area in bathroom #1. Exit doors are free of any obstruction. Backyard was inspected and there were no debris or any obstructions. Kitchen knives, sharps objects, cleaning supplies and toxic substances are locked and inaccessible to clients. There is one (1) fire extinguisher observed to be fully charged and was last serviced on April 14, 2022. 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. At 11:40am, hot water supply measured 112.7 deg F in the kitchen, and 114.9 deg F in bathroom #1.