Facility Evaluation Report

Licensing Program Analyst (LPA) Tena Herrera conducted the required annual inspection. LPA arrived met with Licensee Debra and Administrator Briana and explained the purpose for today’s visit. The facility is licensed to serve (4) Ambulatory Only Clients Ages 18-59 years. The facility currently has (0) clients.

This facility is a single story house located in Bellflower, Ca. A tour of the facility includes: 2 client bedrooms, 2 full bathrooms, living room, family room, dining area, office area, laundry area, front yard, back yard and attached garage.

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

Infection Control: 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. Passageways are free of obstruction. No bodies of water were observed at the facility. All storage areas for cleaning solutions, toxins, knives, and hazardous items have a designated locked area that is inaccessible. Smoke detectors and carbon monoxide detectors are operable and in compliance. There fire extinguisher was observed and is fully charged. Food Service: The kitchen was observed for the ability to prepare and serve food. Operational Requirements & Staffing & Personnel Records-Training : There are currently no staff due to no clients, however, administrator and licensee are aware of the required training, fingerprint clearance that staff must complete prior to working with clients. Administrator Briana Broach has a valid administrator certificate expires 2/22/26. Client Rights Information & Client Records-Incident Reports: Internet and Telephone are connected and readily available for client use. Client rights posters and reporting posters are displayed within the facility. There is a designated locked area where client files and medication will be maintained. Disaster Preparedness: The facility has an Emergency Disaster Plan and will conduct the required drills once staff/clients are brought on board.

Per California Code of Regulations, Title 22, and California Health and Safety Code, there were no deficiencies observed during the visit. Exit interview held and a copy of the report was provided.