Facility Evaluation Report

On 11/19/2023 at 8:00 am Licensing Program Analyst (LPA) David España conducted an unannounced Required-1-year annual visit. Upon arrival at the facility, LPA España conducted a risk assessment at the front door. Based on the assessment, the facility is clear of Covid-19 infection (No COVID-19 cases). LPA verified that the facility has an approved mitigation plan report. LPA was granted access and allowed to enter the facility to conduct the inspection.

LPA was met by David Vaughn Senior; Administrator and the purpose of today’s visit was explained. Adult Residential Facilities (ARF) facility is licensed to serve 4 ambulatory, developmentally disabled adults 18 - 59 years only. There are currently (3) West-side Regional Center consumers in placement. All (3) clients are ambulatory. (0) non-ambulatory. The facility is a single-story structure located in a residential neighborhood. It consists of the following: 3 bedrooms, 2 bathrooms, living room, kitchen, dining room, shaded area, indoor and outdoor activity area, laundry area next to kitchen, and a detached garage. LPA and Administrator toured the entire facility inside and out. Documents are posted as mandated by the DPH and CCLD. Bedrooms #1 & #2 are occupied by clients and contain the mandated furniture. Bedroom #3 is a staff bedroom. Bathrooms #1 has a black mold back of toilet. Bathroom #2 is a staff bathroom. Smoke detectors and carbon monoxide detectors comply and are operational. No firearms are stored at facility and no bodies of water present. Medications are stored, locked and inaccessible to clients. The water temperature measured at 105 degrees Fahrenheit. A comfortable temperature is maintained in the facility. Ample supply of perishable and nonperishable food, linens and personal hygiene supplies are adequate, hazardous toxins and/or items are inaccessible to clients, (2) fire extinguishers are fully charged. First Aid kit complete and has manual. Exit, front and back yard are free of debris and/or hazards. The facility is in good repair. A comfortable temperature was maintained in the facility. Smoke detectors are interconnected and operational.LPA observed the facility was found to be appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. Evaluation Report Continues on LIC 809C