Senior Care Records.

Facility Evaluation Report

California Mentor - Dominguez Home, Carson07/14/2023Licence 198602255

Capacity3
Census3
Date signed07/14/2023 03:45:07 PM
The inspector’s account

On 04/11/22, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced annual required visit with a primary focus on Infection Control measures using the CARE Inspection Tool. LPA met with Yesenia Vargas . LPA explained the purpose of today’s visit. The facility is licensed to operate for three (3) non-ambulatory ages 18 through 59. The clients are Harbor Regional Center consumers.

During the visit LPA did audit of client's #1-#3 (C1-C3) service files P&I resources and it revealed to be complete. Interviews were conducted with (2) clients. Client #3 was unavailable for an interview as client was out in the community.

Due to unforeseen circumstances, the administrator is unavailable to be at the facility and DSP Vargas will need to leave to pick up client from Day Program. No one will be at the home from 1:30 pm - 4:00 pm.

An Annual inspection continuation will be conducted a later date.

An exit interview conducted with Yesenia Vargas and a copy of the report provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction