Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced Required 1- year visit focusing on COVID-19 Infection Control Practices. LPA met with DSP staff Adelia Gomez and explained the purpose of the visit. Administrator Mary Gonzales arrived shortly after. The facility currently serving three (3) level 4 developmentally disabled clients over the age of 60, and one (1) level 4 developmentally disabled client under 59 years old. Three (3) of the four (4) clients have restricted health conditions. The facility is licensed for four (4) non ambulatory developmentally disabled adults ages 18 to 59 years old. All clients are served by Harbor Regional Center.

The facility is a single-story home located on a residential cul-de-sac. LPA and Administrator Gonzales toured the facility which consist of an open yard, four (4) bedrooms, two (2) bathrooms, staff office, kitchen, living room, dining room, den/activity room, outdoor covered patio, and attached garage with laundry area. The last fire drill was conducted on 09-19-22.

LPA observed COVID-19 Infection Control screening and signs to be posted in the entrance, common areas, hallways, and bathrooms. Signs encouraging hand washing, cough/sneeze etiquette, and physical distancing were observed. LPA observed drawer in kitchen containing bleach, glass cleaner, toilet bowel cleaner and other chemicals to be unlocked and broken. LPA observed all client bedrooms to contain a bed, linen, dresser, chair, light, and sufficient closet space. LPA tested water in bathroom #1 at 106F degrees and bathroom #2 was tested at 109.2 F degrees which is within the required 105F-120F degrees. Lights were not working in bathroom#1. Per DSP Staff Gomez, the light went out this morning and reported it to management immediately. LPA observed PPE supply located in the garage. Facility has approved COVID-19 Mitigation Plan and staff were observed to be wearing surgical masks. LPA reviewed four (4) client medication records. Medications are documented and stored in a locked rolling cabinet located in the kitchen area. Staff and resident files were not reviewed during today’s visit.

Exit interview was conducted with Administrator Gonzales. A copy of the report/ appeal rights were issued.