Facility Evaluation Report

Licensing Program Analyst (LPA) Ana Soto conducted an unannounced Annual inspection visit and infection control inspection to the above facility. LPA was met by Tina Amaechi, Care giver and the purpose of today’s visit was explained.

There are currently (1) one Regional Center consumers in placement . All (1) clients is ambulatory. The facility is a single-story structure located in a residential neighborhood. It consists of the following: 3 bedrooms, 1 bathroom, living room, kitchen, dining room, shaded area, indoor and outdoor activity area, laundry room and a attached garage.

LPA and care giver toured the entire facility inside and out. Documents are posted as mandated by the DPH and CCLD. Bedrooms 1 is occupied by client and contain the mandated furniture. Bedroom 2 & 3 are not occupied by clients. The (1) bathroom is clean and operational. Smoke detectors and carbon monoxide detector are in compliance and operational. No firearms are stored at facility and no bodies of water present. Medications are stored, locked and inaccessible to clients. A comfortable temperature is maintained in the facility. Ample supply of perishable and nonperishable food, linens and personal hygiene supplies are adequate, hazardous toxins and/or items are inaccessible to clients, 2 fire extinguishers are fully charged. First Aid kit complete and with manual. Exit, walkways and/or passageways, front and back yard are free of debris and/or hazards. The facility is in good repair. During the visit, LPA observed the facility infection control practices. LPA observed a sanitizing station at the facility entry, sanitizer/soap in the bathroom and additional sanitation supplies in a garage. LPA observed staff and clients wearing masks, an isolation room and required postings throughout the facility. The administrator advised LPA that sanitizer is administered to client with the supervision of staff. The facility has an approved Mitigation plan. Visitors are logged and checked. The client’s temperatures are checked and logged 2x a day. Client is vaccinated. All 3 temporary staff are vaccinated.

According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe any deficiencies, therefore no citations were issued at this time.

An exit interview conducted with Tina Amaechi , care giver and copy of report provided.