Facility Evaluation Report

An unannounced Required One (1) year visit was conducted on this day by Licensing Program Analyst (LPA) Gary Tan. LPA initially met with staff Olawumi Robinson who called the administrator Nichelle Mathis and designated Ms. Robinson to sign the report. Purpose of the visit is stated. This is a Lanterman Regional Center vendored facility Specialized Level.

LPA conducted physical plant tour inside and out at 3:34 PM. During the tour, LPA observed that the facility has four (4) bedrooms and two (2) bathrooms. There is no body of water in the facility. The facility is fire cleared for four (4) non-ambulatory residents, one of which may be bedridden.

The front door is the main entrance being utilized at the facility but there is another door parallel to the main door leading immediately to the dining area where the sign in sheet and screening station is located. Sign in sheet, hand sanitizer, gloves and masks are available. The facility had submitted and approved Mitigation and Infection Plan.

All trash cans were observed to be with cover. The facility has a designated visitors' area at the front yard. The facility has sufficient stock of PPE in the storage

Bedrooms were toured and observed to be clean and appropriately furnished.

Bathrooms were observed to be clean, sanitary and with necessary supplies. Hot water temperature measured at range of 107. 7°F .