Facility Evaluation Report

Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced required 1-year annual visit with the primary focus on Infection Control measures and using the new CARE Inspection Tool. Upon arrival at the facility. LPA Bunker met with staff member Sherolyn Moore and explained the purpose of today's Annual Inspection. LPA verified that the facility has an approved mitigation plan report and infection control plan. There are currently two (2), Westside Regional Center Adult Residential Care Facility (ARF) consumers in placement.

The facility is a single-story-family home located in a residential neighborhood. Licensee Ms. Johnson and LPA Bunker toured the facility which consisted of the following: Living room, dining room, kitchen, 3 bedrooms, 1 bathroom, laundry room, shaded area, indoor/outdoor activity areas, and detached garage. The front and back yard landscape is in good condition at the time of visit.

Due to time constraints, LPA will need to return at a later date to complete the annual visit.

LPA Bunker provided staff with a copy of the LIC809.