Facility Evaluation Report

Licensing Program Analyst (LPA) Luis Mora conducted an unannounced annual visit at the facility with focus on the infection control domain, medication and food review. LPA Mora met with Co-Administrator Ayub Walayat and explained the reason for the visit. The facility is an Adult Residential Facility for Persons with Special Health Care Needs (ARFPSHN) and it is licensed to serve 5 bedridden adults. Facility currently has 3 bedridden clients serviced by the South Central Los Angeles Regional Center.

The facility is in a residential area and it is a one story family home. A tour of the single-story facility included the following: 5 client bedrooms, 2 bathrooms, kitchen, living room, dining room, patio, front yard, backyard, and am attached garage.

LPA Mora conducted the tour with Ayub Walayat and observed the following: sufficient food supplies for at least 2 days of perishables and 7 days of non-perishables were observed in the kitchen. Sharps were observed locked in a kitchen cabinet. Chemical and cleaning solutions are kept locked under the kitchen sink. The First Aid kit is kept locked in the living room and it is fully stocked with all required items including a current manual. Clean towels and extra clean linen were observed in the hallway cabinet. Dining and living room have sufficient lighting and sitting area. Medications are kept locked in a cabinet near the kitchen. Client files and staff files are kept in the garage. All bedrooms have all required furniture, lighting, and bedding. All bathrooms were observed with shower mats. The water temperature was tested in both bathrooms and measured at 112.4 degrees F and 114 degrees F, which is within the required 105-120 degrees F. A fire extinguisher was observed in the kitchen, living room, and garage and are fully charged. Smoke detectors and carbon monoxides were observed throughout the facility and were operable during the visit. The facility has sprinkler system in place. The emergency generator was last tested on 08/23/22, it is tested every 14 days. The front yard and backyard are clean. There is a shaded area with seating in the patio. No bodies of water were observed at the facility. Passageways and exits are free of obstruction.