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 Shiela Masuecos, Direct Support Professional I & II (DSP I & II) and Angelito Flores, Direct Support Professional I (DSP I) and explained the purpose of the visit. Irene Genaskey, Program Staff arrived at 11:00am and Ariel Resurreccion, Administrator arrived at 12:00pm and assisted LPA with the inspection. The facility is licensed to care for (4) Developmentally Disabled Adults, (2) ambulatory and (2) non ambulatory, ages 18 through 59. All clients at this facility receive case management services from Harbor Regional Center. The facility is a level 4I.

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 maintained. The staff stated that they use disposable gloves to clean and disinfect the high touched surfaces in the common areas. The facility has submitted a COVID-19 Mitigation Plan and the Infection Control Plan. Bathrooms have hand soap, paper towel and toilet paper. Staff are adhering to infection control requirements

Physical Plant/Environment Safety: The facility is a single storey home located in a residential neighborhood, contains a total of (4) client bedrooms, (3) bathrooms, a living room/activity area, family room/office area, kitchen, dining area, backyard with shaded area, and detached garage. Currently, there are four (4) clients living in the facility. The interior and exterior physical plant was inspected. Client bedrooms were toured. Each bedroom has a smoke detector, bed, linen, dresser, light, chair and sufficient closet space. Bathrooms have non-skid materials and contained hygiene supplies including liquid soap, and toilet paper. There is a fire place in the living room that is covered and inaccessible to clients. Kitchen was inspected and LPA observed (1) fire extinguisher mounted on the wall in the kitchen which is operable and was serviced on 03/30/2023. Exit doors are free of any obstruction and there are no pools or large bodies of water. Backyard was inspected and has a shaded area and sitting area. Laundry area is in bathroom #1. There are cameras in the front yard only. 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. Readings were 113.5 deg. F in bathroom #1, 114.4 deg. F in bathroom #2 and 113.7 deg F in bathroom #3.

Operational Requirements: A current Plan of Operation was reviewed. The Infection Control Plan has been added to the Plan. A fire clearance is in place. Liability Insurance policy in the amount of $1,000,000.00 each occurrence and $3,000,000.00 in the total annual aggregate is valid and expires on 03/14/2024. Surety Bond in the amount of $2000 is in effect until 01/11/2026. Last Fire Drill was conducted on 02/02/2024. *****REPORT CONTINUED ON LIC809-C*****