Facility Evaluation Report

A Required Annual visit was conducted today by Licensing Program Analyst (LPA) Gary Tan. LPA met with the administrator Tammy Chambers and explained the reason for the visit. This is a North Los Angeles Regional Center vendored facility level 3.

At 10:04 AM, A tour of the physical plant was assessed and the following was noted:

The only entrance being utilized is the main front door, there is a sign at the main door that everyone entering at the facility must be screened. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available. The facility had submitted and approved Mitigation and Infection plan.

Signs to wear a mask and other Covid 19 prevention protocol signs were posted inside immediately upon entrance. Hand washing, coughing etiquette, physical distancing and other necessary signs were posted in the bathroom and all over the facility. All trash cans were observed to be with cover. The facility has a designated visitors' area at the backyard. The facility has sufficient stock of PPE in the storage room.

The facility has four (4) private client bedrooms and one (1) bathroom. There is one (1) additional bedroom and one (1) bathroom designated for staff use double as an as an office. There is no body of water in the facility.

Bedrooms were toured and observed to be clean and properly furnished. Linen storage was also checked and observed to have ample supply of clean linen and towels.

Bathrooms were observed to be clean and sanitary with necessary supplies. Hot water temperature was measured at 108.1°F and within the required range. (continued on LIC 809-C)