Facility Evaluation Report

Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year visit focusing on COVID-19 Infection Control Practices. LPA knocked at the door for 10 minutes; there was no answer. Licensee was called and Assistant Administrator Administrator Johnny Sarkisyan arrived shortly after. Administrator Serop Sarkisyan also arrived shortly after. There are three (3) level 4 developmentally disabled clients over the age of 60. The facility is serviced by Lanterman Regional Center. The facility is a single story home located in a residential neighborhood that is licensed for 6 non-ambulatory clients. A hospice waiver for 3 residents is in place. It consists of 6 bedrooms, 2 bathrooms, living room/dining area, kitchen with laundry area, outdoor covered patio, and detached garage. The last fire drill was conducted on 3/5/2022.

COVID-19 Infection Control screening and signs were observed in the entrance, common areas, hallways, and bathrooms. Signs are posted throughout the facility to promote hand washing, cough/sneeze etiquette, and physical distancing.

Facility has an approved COVID-19 Mitigation Plan.

Each resident room has been designated as a COVID-19 solation room if needed.

Three (3) centrally stored resident medication records were reviewed.

Staff was observed wearing a surgical mask.

Clients in care do not wear masks because they lack hazard awareness and impulse control.

Sufficient supply of perishable for 2 days & non-perishable foods for 7 days were observed.

A posted Emergency Disaster Plan was observed.

Sufficient supply of Personal Protective Equipment (PPEs) was observed.

Insect poison control bottles were observed unlocked in the rear patio area. The detergent cabinet was also unlocked.

NOTE: Technical advisory- Licensee was advised to install a door bell at the front door. Staff did not hear LPAs door knocks during today's visit.

Exit interview was conducted with Administrator Serop Sarkisyan. A copy of the report was issued.