Facility Evaluation Report

Licensing Program Analyst (LPA) Jose Villalobos conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA met with Administrator Mellad Falatoonzadeh and the purpose of the visit was discussed. The following (CARE) tool domains were utilized during the inspection:

Infection control practices and Personal Protective Equipment (PPEs) were observed. COVID-19 screening is no longer in place. The facility has an Infection Control Plan for LPA to review.

A current Plan of Operation was reviewed.

A fire clearance for four (4) ambulatory clients of which (3) may be non ambulatory;0 may be bedridden. Delayed Egress granted

The facility is located in a residential area. The single-story facility includes: Living room/den, kitchen/dining area, laundry area, pantry, attached garage/office, 4 bedrooms and 2 bathrooms.

The physical plant was inspected. Exit doors are free of any obstruction and there are no pools or large bodies of water. Cleaning supplies and toxic substances are inaccessible to clients. Facility is enclosed in locked fencing with delayed egress. Fire Alarms were inspected. Fire extinguishers Observed

Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. Water sprinkler system is in place. System is inspected yearly by the fire department.

Sufficient staff observed to meet clients needs

Facility currently provides care and supervision for a total of three (3) Clients.