Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Wong conducted an annual required visit. LPA met with Caregiver Judith Delos Reyes and explained the reason for the visit. LPA used the infection control tool to evaluate the facility. LPA's observed the facility plant, COVID-19 procedures and observed food supply, and reviewed clients files. Facility has submitted a mitigation plan and was approved 03/10/21.

The facility is a single story house and located in a residential neighborhood. The facility consists of living room, kitchen, dining area, four clients bedrooms, two bathrooms and an attached garage. LPA toured the client's bedroom. Each room has one bed, one dresser, one chair, required linen, sufficient lighting and closet space. The bathrooms are clean and operational. The hot water temperature was measured between 125 and 127 degrees F which is out of the range of Title 22 regulation. The food supply in the refrigerator and garage which included two days perishable and seven days non-perishable. All the appliances are clean and working properly. The common areas such as living room and dining area are clean and have the required furniture. The front and back yard are maintained well and has a shaded with table and chairs for clients to utilize. The exit and passage way are free of obstruction. The sharp utensils are locked in the kitchen cabinet and the cleaning supplies are located in the garage and inaccessible to clients. The medication are centrally stored and locked in the kitchen cabinet and inaccessible to clients. The smoke detectors and carbon monoxide detectors are located in each client bedroom and common area and they are operating well.

Facility is currently following COVID 19 recommendations regarding COVID 19 signs throughout the facility, facility is disinfected every day or as needed or every time client used, the bathrooms have sufficient soap, paper towels, and signs and PPE supplies are stored for more than 30 days.