Facility Evaluation Report

Licensing Program Analyst (LPA) Daniel Konishi conducted the unannounced Annual Inspection and met with Assistant Administrator Julie Machado who allowed the entry of the facility and explained the reason of today's visit and will be using the Compliance And Regulatory Enforcement (CARE) Tools to inspect the facility. Norlan Machado, Staff arrived and assisted LPA with the visit. This home is licensed to serve (4) Developmentally Disabled Ambulatory Adults, (4) Ambulatory Adults ages 18 through 59. The home is vendored through Harbor Regional Center.

The following 12 (CARE) tool domains were observed and reviewed: Infection Control, Physical Plant/Environment Safety, Operational Requirements, Staffing, Personnel Records/Staff Training, Client Rights/Information, Client Records/Incident Reports, Food Service, Health Related Services, Incident Medical Services, Disaster Preparedness, and Emergency Intervention.

Infection Control Plan: The facility has an updated Infection Control Plan in place. The staff practice hand washing and using gloves in the facility. Staff would clean and disinfect once a day and more often for high touched surfaces area. Facility has sufficient PPE supplies.

Physical Plant and Environmental Safety: The facility is a single-story house and located in a residential neighborhood area. The facility includes kitchen, living room, dining area, four (4) client’s bedrooms, staff bathroom, two (2) client bathroom, laundry room and an attached garage. Bedroom#1 has two beds, two chairs, two drawers, required furniture and beddings and sufficient lighting and closet space. Bedroom#2 and #3 has one bed, one chair, one night stand, one drawer, required furniture and bedding and sufficient closet space and lighting. The client bathroom is clean, sanitary and in a good working condition. Toilets and faucets are in working condition. The hot water temperature tested between 119 and 119.5 degrees F which is within the Title 22 regulation.