Facility Evaluation Report

Licensing Program Analyst (LPA) Erik Zaragoza conducted an unannounced Required 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA explained the purpose of the visit to Christina Jimenez a DSP staff member. Administrator Samira Menendez arrived shortly after. There are four (4) ambulatory developmentally disabled clients who reside in the home. The facility is an Adult Residential Facility (ARF) vendored by South Central Los Angeles 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 and Dental, Disaster Preparedness, and Emergency Intervention.

· Infection control practices and Personal Protective Equipment (PPEs) were observed. The facility had an Infection Control Plan and emailed it to the LPA for documentation.

· The facility is a single-story home located in a residential neighborhood that is licensed for four (4) ambulatory clients. It consists of 2 client bedrooms, a living room, dining room, a kitchen, 1 (one) bathroom which measured at 116.5 degrees Fahrenheit, a backyard patio area, and a detached garage.

· The interior and exterior physical plant was inspected. Exit doors are free of any obstruction and there are no pools or large bodies of water. Smoke and carbon monoxide detectors are operational. The facility has one (1) fully charged fire extinguisher. Cleaning supplies and toxic substances are inaccessible to clients.

· Water temperature readings measured between the required 105 - 120 degrees Fahrenheit.