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 evaluation, the facility is clear of COVID-19 infection. LPA was properly screened for COVID-19 symptoms, and their temperature was checked. LPA Bunker met staff member Frank Jacque 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 is currently one (1) Westside Regional Center (WRC) Adult Residential Care Facility (ARF) consumer 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."

Staff member Mr. Jacque and LPA Bunker toured the facility, which is a single-story family home located in a mixed residential-commercial neighborhood. The home includes a living room, family room, dining room, kitchen, 3 bedrooms, 2 bathrooms, a laundry/office area, and an indoor/outdoor activity space, a shaded patio with outdoor furniture, a table, and seating chairs. Bedrooms #1-3 are designated as the client's bedrooms.