Facility Evaluation Report

Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced Case Management - Annual Continuation 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 evaluation, 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.

The following 12 Domains will be observed and reviewed: Infection Control, Physical Plant & Environmental Safety, Operational Requirements, Staffing, Personnel Records-Training, Client Rights-Information, Client Records-Incident Reports, Food Service, Health-Related Services, Incidental Medical Services, Disaster Preparedness, and Emergency Intervention. "LPA Bunker will be using this tool and methods that have been developed to improve the efficiency and accuracy of the Department of Social Services' facility inspections."

LPA Bunker and Staff member Juanita conducted a tour of the facility, which is a single-story family home located in a residential neighborhood. The home includes a living room, dining room, kitchen, three bedrooms, two bathrooms, a laundry area, an office space, a detached garage, and an indoor/outdoor activity area. There is a shaded outdoor space furnished with patio furniture, including tables and chairs.

LPA Bunker observed the facility’s infection control practices, which included screening protocols for residents and visitors, the availability of hand sanitizer, a visitor log, and the use of thermometers at the facility entrance. See continued LIC809-C page 2