Facility Evaluation Report

Licensing Program Analyst (LPA) Alberto Lopez conducted an unannounced Required- 1-year visit focusing on COVID-19 Infection Control Practices. LPA was greeted by DSP Kyerhon King and Administrator James Calhoun arrived around 60 minutes later and LPA explained the purpose of the visit. Administrator certificate expires 05/13/2022 Last fire drill was on 09/06/2021. Clients are from Lanterman Regional Center Home and is a level 4 specialize.

Facility has a maximum capacity of five (5). A tour of the physical plant was conducted. The Facility consist of a single family, one (1) story dwelling (Main House) with an additional detached living area (Pool House)

· COVID-19 signs are posted at the entrance. Visitors are screened in the main entrance and a log is kept.

· Infection control signs and other COVID-19 signs are posted throughout the facility in the bathrooms, kitchen, and hallway to promote handwashing, cough/sneeze etiquette, and physical distancing.

· 4 client rooms, common areas, bathrooms, and outdoor physical plant was inspected.

· No client rooms are equipped with alcohol-based hand sanitize but available at facility

· Four (4) centrally stored client medication records were reviewed.

· Staff responsible for direct care and supervision were observed wearing masks.

· Clients were not at facility at time of visit but 1 arrived later.

· Sufficient supply of perishable for 2 days but non-perishable foods for 7 days were not observed.

· A posted Emergency Disaster Plan was observed posted at facility.

· Staff and resident files were not reviewed during today's visit.

The following deficiencies were observed to be in violation of California code of Regulations, Title 22, Division 6 (refer to 809D)

Exit interview was conducted with Administrator James Calhoun. A copy of the report was provided.