Facility Evaluation Report

Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced Annual Required 1-Year 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 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 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 Licensee Mrs. Clarke toured the facility, a single-story family home located in a residential neighborhood. The home features a living room, dining room, office area, kitchen, and a laundry area within the kitchen. It includes four (4) bedrooms and two (2) full bathrooms. The facility also offers a patio/shaded area, an indoor/outdoor activity space in the backyard, and a detached two (2)-car garage. There are three (3) exits located in the kitchen, the living room, and one of the bedrooms. At the time of the visit, both the front and backyard landscaping were in good condition. Bedrooms #1 through #3 are designated for clients, while Bedroom #4 serves as a staff lounge.