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 with staff Pearl Cash and explained the purpose of today's Annual Inspection. LPA verified that the facility has an approved Mitigation Plan and Infection Control Report. There are currently two (2), Westside Regional Center consumers and in placement. 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."

Staff Pearl Cash 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 area, kitchen, TV/family room/office area, three (3) client bedrooms, two (2) bathrooms (one bathroom used for staff), a washer/dryer located in the garage, attached garage, and an indoor/outdoor activity area. There is a shaded backyard patio sitting area furnished with outdoor patio furniture, including tables and chairs.