Facility Evaluation Report

Licensing Program Analyst/ (LPA) Jose Villalobos conducted an unannounced annual inspection visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA met with Administrator Bianca Alexander and the purpose of the visit was discussed.

Structure/Physical Plant: The facility is licensed for four (4) clients ages 18-59, of which may include (4) ambulatory residents. The facility is vendorized through Eastern Los Angeles Regional Center. The facility is a one story house located in a residential neighborhood consists of three (3) bedrooms. Bedroom #1 and #2 are for one (1) client. Bedroom #3 is for up to (2) clients. There are (2) bathrooms of which (1) is for client use. There is also a living room, an office, a kitchen, central air and heating, a dining area, a shaded area located in the backyard. A detached car garage inaccessible to clients. Accommodations : Adequate accommodations observed throughout facility. Hallway and Doorways: Free and clean of obstruction and debris. Client Rooms: All bedrooms are equipped with: overhead lighting, chair, night stand, lamp in addition to overhead lighting, large drawer, and closet space. Bathrooms: All bathrooms have a working toilet, wash basin, shower, grab bars and nonskid mats. Linens & Hygiene Supplies: Required linen/supplies observed. Emergency Phone Numbers, Exit Plan & Menu: Facility has a working phone landline. There is a cordless phone for client use. Fire Extinguishers observed Food Service: All food and adequate utensils such as, dishes, cups, bowls and plates observed. Supply of perishables and non-perishables observed. Smoke Detectors & Fire Extinguishers: Detectors Electrical & connected. All detectors operational. Toxins: Locked/stored for staff use only. Hot Water Temperature: Measured between 110 -115 degrees all around the home. Medications, First-Aid Kit & Book: Medications centrally stored and inaccessible to clients. First aid kit observed. Postings: Wall postings observed. Residents & Staff Files : LPA reviewed (4) of (4) client medication records and files , as well as five (5) Staff Files . Emergency Disaster, Infection Control, and Plan of Operation also observed and reviewed.

Inspection tool completed and no deficiencies are being cited. Exit Interview conducted and a copy of this report was provided