Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Wong conducted an unannounced annual required visit. LPA met with Lead Staff Eden Tupuola and explained the reason for the visit. LPA used the infection control tool to evaluate the facility. LPA observed the facility plant, COVID-19 procedures, reviewed clients' medications, observed food supply, and reviewed client and staff files.

The facility is a single story house and located up on the hill around the residential neighborhood area. The facility includes: staff office, art and craft room, living room, kitchen, four clients bedrooms, client bathroom, staff bathroom, laundry room, basement storage room and a detached garage. All 4 clients bedrooms were toured. Each bedroom has one bed, one chair, one drawer, required bed linen and furniture, sufficient lighting and closet space. The clients bathroom was toured and they are clean, sanitary and in a good working condition. The hot water temperature in client bathroom was tested at 109 degrees F. which is within the Title 22 regulation. The refrigerator in the kitchen, kitchen cabinet and basement storage room have sufficient for 2 days perishable and 7 days non-perishable food supply. All the appliances in the kitchen are clean and working properly. The sharp knives and utensils and knobs are locked in the kitchen cabinet which is inaccessible to clients. The common area such as living room and dining area are clean and have the required furniture. All the cleaning supplies are stored in the basement storage room and its locked and inaccessible to clients The front and back yard are maintained well and back yard have a shaded area for tables and chairs for clients to use it.

LPA reviewed 2 clients files to confirm emergency contact is updated. LPA also reviewed two staff files to confirm health screenings and fingerprint clearances. The two staff are all fingerprint cleared and also have an updated health screening updated on the personnel file. All clients medication are centrally stored and locked in the cabinet near the bedrooms. LPA inspected three clients' medication and all the medication are all seemed updated and accurate.