Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Wong conducted the required annual inspection. LPA arrived unannounced and met with the DSP Danielle Tena who allowed the entry of the facility and later on, the administrator Glorie Pascasio arrived and assisted with the visit. The purpose for the visit was explained. The facility is licensed for age range 18 through 59 for non-ambulatory.

LPA Wong utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and here are the domains that LPA inspected:

1. Infection Control: The facility staff are using appropriate hand hygiene and wearing gloves while assisting clients. Staff are cleaning and disinfecting at least once a day and more often for high touched surfaces area. Facility has sufficient PPE supplies and has an Infection Control Plan.

2. Physical Plant and Environmental Safety: The facility is a single story house and located in a residential neighborhood area. The facility includes: living room, kitchen, dining area, staff office, activity/family room, four clients bedrooms, two clients bathrooms, medication closet and attached garage. All clients bedrooms have one bed, night stand, chair, table, drawer, closet, required bedding and sufficient closet space and lighting. All two clients bathrooms are clean, sanitize and in a operable condition. The hot water temperature tested in two bathrooms were between 119.6 and 120 degrees F which is within the Title 22 regulation. LPA inspected the smoke detectors and carbon monoxide detectors and they are interconnected and located in each clients bedrooms and common area and they are working probably. The facility room temperature is within the required limit. LPA also observed the facility has ample supply of personal hygiene products and they are stored in the medication closet. The facility also has a telephone service on the premises.

3. Operational Requirements: The facility maintained a fire clearance approved by the fire department which they currently have all four non ambulatory clients only. The facility also has shaded area with table and chair for client to utilize for outdoor activity. The last fire and disaster drill was conducted on 3/3/23