Facility Evaluation Report

Licensing Program Analyst (LPA's) Tena Herrera and Elena Mallett conducted the required annual inspection. LPA arrived unannounced and met with Ayub Walayat and explained the purpose for today’s visit. The facility is licensed to serve (5) bedridden adults.

The facility is a single-story home located in a residential area in Downey, Ca. A tour of the facility includes: 5 bedrooms, 1 full bath, 1 half bath, living room, dining area, laundry area, detached garage, front yard and back yard.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: The facility maintain the required Infection Control Plan.

Physical Plant & Environment Safety: LPA toured facility, clients’ bedrooms were checked and closet/drawer space to accommodate each client comfortably was available. The backyard is free of debris/hazards and the outdoor and passageways are free of obstruction. No bodies of water were observed at the facility. There are no security bars or weapons on the premises. Hygiene products are readily available for clients. The hot water temperature was tested and was within the required range of 105-120 degrees F. All storage areas for cleaning solutions, toxins, knives, and hazardous items are kept in a locked cabinet and are inaccessible to clients. Smoke detectors and carbon monoxide detectors are operable and in compliance. There fire extinguisher was observed and is fully charged.

Operational Requirements: Administrators are knowledgeable in their reporting requirements for the Adult Residential Facility for Persons with Special Health Care Needs and events that must be reported to licensing within either 2 hours or 24 hours of occurrence.