Facility Evaluation Report

Licensing Program Analyst (LPA) Mario Leon conducted an unannounced Annual Required visit. LPA Leon informed Debra Davenport, House Manager, of the purpose for today's visit. LPA Leon reviewed the physical plant, medications, food service, clients and staff records, consumer IPPs, and first aid certificates, verified that the administrator is present at the property 20+ hours per week. LPA Leon verified all current staff fingerprint cleared/associated to the facility, noted one Direct Support was not associated. The facility annual fees are current. There are currently four (4) Westside Regional Center (WRC) consumers in placement.

The facility is a single story, 3 bedrooms, 2 bathrooms home located in a residential neighborhood.

The facility has a living room, dining room, kitchen, laundry room in the detached garage, shaded area, indoor/outdoor activity areas.

Bedrooms #1-3 are designated as client bedrooms. Bedroom number three (3) is the only shared room.

Documents are posted as mandated. Bedrooms contain the furniture mandated. Bathrooms are clean and operational yet outside of Title 22 regulations. Bathroom #2 was measured at 152.2 F, first aid kit is fully stocked, smoke detectors were in compliance, medications cabinet / Sharps found unlocked and records need upkeep. Perishable food was enough, but needs a fresh supply of perishable and nonperishable food, hot water temperature above Title 22 regulations as noted above, adequate linen supply, hazardous cleaning solutions are inaccessible to clients, yard was free of debris/hazards.

Administrator certificate is current, expires 09/09/24.

During this inspection there were five (5) deficiencies noted, see LIC809-D.

An exit interview was held and a copy of the report and appeal rights, were provided to Debra Davenport, House Manager.