Facility Evaluation Report

Licensing Program Analyst (LPA) Daniel Konishi conducted an unannounced visit at the facility for the purpose of conducting the required annual inspection. LPA utilized the Compliance and Regulatory Enforcement (CARE) Tool to evaluate the facility. LPA Konishi met with Administrator, Mary Gonzales and explained the purpose for the visit.

The facility is licensed to serve a total of four (4) non-ambulatory developmentally disabled adults between the ages of 18-59, one restricted conditions, approved hospice waiver for one (1). Currently, there are four (4) clients in placement, there is a client who has a restricted health care condition. All clients residing at this facility receive case management services provided by Harbor Regional Center.

The following 5 (CARE) tool domains were observed and reviewed: Infection Control, Physical Plant/Environment Safety, Operational Requirements, Staffing, and Personnel Records-Training.

During the visit LPA observed the following:

Infection Control: The facility staff are using appropriate hand hygiene and wearing gloves while assisting clients. Staff are cleaning and disinfecting often for high touched surfaces. Facility has sufficient PPE supplies, has an Infection Control Plan. Facility has COVID-19 signage posted throughout the facility. Bathrooms have hand washing signs, soap, and paper towels. Facility Administrator is adhering to infection control requirements.

Operational Requirements: Emergency Fire Drill was conducted on 12/07/2024. Emergency Disaster/ Earthquake Drills was conducted on 12/07/2024. Facility Administrator is adhering to operational requirements.