Facility Evaluation Report

Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced Annual/Required 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 Bunker was properly screened for COVID-19 symptoms and temperature was checked. LPA Bunker met with House Manager Deborah Lewis 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 three (3), Westside Regional Center Adult Residential Care Facility (ARF) consumers in placement. The facility's annual fees are current.

The following Domains will be observed and reviewed: Infection Control, Physical Plant and Environmental Safety, Operational Requirements, Staffing, Personnel Records-Training, Clients Rights-Information, Clients Records-Incident Reports, Food Service, Health-Related Services, Incidental Medical Servces, 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.

The facility is a single story-family home located in a residential neighborhood. House Manager Ms. Lewis and LPA Bunker toured the facility which consisted of the following: Living room, dining area, family room, kitchen, 5 bedrooms, 3 bathrooms, laundry area, shaded area, indoor/outdoor activity areas, and a two car detached garage. The front and back yard landscape is in good condition at the time of the visit.