Facility Evaluation Report

Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced required 1- year visit with the primary focus on Infection Control measures and using 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 temperature was checked. LPA Bunker met Center Director Jae Lim and explained the purpose of today's Annual Inspection. LPA verified that the facility has an approved mitigation plan report and infection control plan. The facility is licensed to serve (50) ambulatory and (4) non-ambulatory clients aged 18 through 59. Currently, there are 21 clients present during today's visit. The facility has a 1 to 3 ratio. The Adult Day Program annual fees are current.

12 Domains in the Infection Control Practices will be observed and reviewed. "I 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."

The Adult Day Program is located in a single-story commercial business area, operating hours are 9:00 A.M. to 6:00 P.M. 5 days a week Monday through Friday. All clients bring their own lunch or bring money to purchase lunch in the community. If clients forget their lunch the facility staff will provide emergency food for clients.

The day program is a single-story structure located in a commercial building. Mr. Lim and LPA Bunker toured the entire Adult Day Program inside and out which consisted of the following: The Day Program consists of the following: Lobby, reception area, 5 administrative offices, two (2) activity rooms, medication/first aid room, commercial kitchen, conference room, mail room, staff lounge, seven (7) client restrooms and two (2) staff restrooms, 2 restrooms, and pump room, storage garages, and an outside shaded area with a gated parking lot. See continued LIC809-C on page #2