Facility Evaluation Report

Licensing Program Analyst (LPA) Jose Villalobos made and unannounced Annual inspection focused on Infection Control. On today’s visit LPA met with staff Maria Teresa and the purpose of the visit was discussed. Licensee Susana Martinez arrived shortly after.

As a part of the inspection, LPA used the inspection tool, reviewed (5) client records, (3) staff files, and (5) client medications. Currently the facility has (5) clients which are ambulatory. The facility is vendorized through Eastern Los Angeles Regional Center. Facility is a one story family home with four (4) bedrooms, two (2) full bathrooms of which one is attached to bedroom #3, living room, kitchen, central air and heating, dining area, fire place located in the living room (boarded), laundry room, a shaded area located in the backyard. an attached two (2) car garage inaccessible to clients. Front and back yard is in good condition at time of visit. Washer/Dryer appliances observed. Toxins and sharps locked and inaccessible to clients. Bedrooms #1-#3 are equipped with a bed for each client, a dresser, lamp, chair, overhead lightning. Bedroom #4 is for live in staff. Bathrooms have a working toilet, wash basin, one has a bathtub and the other has a shower. Beds have the required linen/supplies which include, pillowcase, mattress padding, fitted sheet, blanket and bedspreads. Supply of hygiene supplies stored in each client's bedrooms were observed. Fire alarms are interconnected and operational. Required postings observed. Water temperature within required tittle 22 regulations.

Infection control domain completed and there were no deficiencies. An exit interview was conducted and a copy of this report was provided.