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 evaluation, the facility is clear of COVID-19 infection. LPA Bunker met with staff member Deborah Lewis and explained the purpose of today's Annual Inspection. LPA verified that the facility has an approved Mitigation Plan and an Infection Control Report. There are currently two (2) Westside Regional Center Adult Residential Care Facility (ARF) consumers in placement. The facility's annual fees are up to date.

The following 12 Domains will be observed and evaluated: 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."

Ms. Lewis and LPA Bunker toured the facility, which consisted of the following: Living room, dining area, family room, kitchen, 4 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. See continued LIC809-C page 2