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 temperature was checked. LPA Bunker met with Licensee Zoie Clarke 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 four (4), Westside Regional Center consumers and The facility's annual fees are current.

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."

Licensee Mrs. Clarke and LPA Bunker toured the facility which is a one-story single-family home located in a residential neighborhood with four (4) bedrooms, two (2) full bathrooms, a living room, dining room, office, kitchen, and laundry area in the kitchen. The facility has a patio/shaded area, an indoor/outdoor activity area located in the backyard, and a two (2) car detached garages. Three (3) exits are located in the kitchen, living room, and bedroom. The front and backyard landscapes were in good condition at the time of the visit. Bedrooms #1-3 are designated as the client's bedrooms. Bedroom #4 is designated for living staff.