Facility Evaluation Report

Licensing Program Analyst (LPA) Tena Herrera conducted the required annual inspection. LPA arrived unannounced, met with Derry Sandajan (House Manager) and explained the purpose for todays visit. The facility is licensed to serve 6 Ambulatory only clients ages 18 to 59 years old. There are currently 4 clients serviced through South Central Los Angeles Regional Center at the facility.

The facility is a single-story home located in a residential area in Downey, CA. A tour of the facility includes: dining area, office area, kitchen, living room, 3 client bedrooms (one shared room), 2 bathrooms, attached garage, front yard, backyard, and a locked toolshed.

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

Infection Control: Facility maintains the required Infection Control Plan.

Physical Plant & Environment Safety: Clients’ bedrooms were checked and closet/drawer space to accommodate each client comfortably was available. Bathrooms are clean and operational. 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. The hot water temperature was tested in client bathroom and measured within the required range of 105-120 degrees. All storage areas for cleaning solutions, toxins, knives, and hazardous items are in a secured cabinet and are inaccessible to clients. Smoke detectors and carbon monoxide detectors are operable and in compliance. The fire extinguisher was observed and is fully charged.

Operational Requirements: Facility has an activity area furnished for outdoor use.

Staffing & Personnel Records-Training : There appears to be sufficient staffing at all times in the facility. Staff files are stored electronically and each staff file has the following: current CPR/First-Aid/CPI training and sufficient on-going training. Princess Torres holds a valid Administrator Certificate that expires on 6/8/2026. LPA reviewed 5 staff files with no issues observed. (Continued on LIC809-C)