Facility Evaluation Report

Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced annual required visit with the primary focus on infection control measures and the use of the new CARE Inspection Tool. Upon arrival at the facility, LPA Bunker conducted a risk assessment. Based on the assessment, the facility is clear of COVID-19 infection. LPA was properly screened for COVID-19 symptoms, and LPA's temperature was checked. LPA Bunker met with staff member Juanita Ricker and explained the purpose of today's annual inspection. LPA verified that the facility has an approved Mitigation Plan Report and Infection Control Report. There are currently three (3) Westside Regional Center consumers in placement. The facility's annual fees are up to date.

Staff Juanita and LPA Bunker toured the facility. The facility is a single-story family home located in a residential neighborhood. Which consists of a living room, dining room, kitchen, 4 bedrooms, 2 bathrooms, laundry area in the garage, office area, detached garage, and an indoor/outdoor activity area. A shaded area furnished with outdoor patio furniture, including tables and chairs. Bedrooms #1-3 are designated as the client's bedrooms, and bedroom #4 is designated as the live-in staff bedroom.

Due to time constraints, LPA was unable to complete the visit and will return at a later date to complete the visit.

There were no deficiencies cited. An exit interview was conducted.