Facility Evaluation Report

Licensing Program Analyst (LPA) Brian Balisi conducted a Pre-licensing visit to the above facility. LPA met with Administrator Pauline Mortel and explained the reason for the visit. This pre-licensing is for a change of ownership. The home is currently operating as Fairhaven Homes Baltar Lic # 19760954 1. This home is licensed to serve (4) ambulatory clients with intellectual disabilities at Level II which North Los Angeles County Regional Center is the vendor. LPA met with Pauline Mortel - Administrator and explained the purpose of the visit.

At approximately 10:30am LPA conducted physical plant along with Administrator. LPA inspected facility for Fire Safety, Personal Accommodations and Services, and Food Service. Smoke detectors and Carbon Monoxide detectors appeared to function properly during time of visit.

Facility is a single-story residence and consists of a total of three (3) bedrooms and two (2) bathrooms designated for clients use. (1) bedroom is designated for staff use at this time. Fire clearance was approved for (4) ambulatory residents. Fire extinguishers were observed to be fully charged and purchased this May 2021. During physical plant tour LPA observed the required postings throughout the facility.

Kitchen: The kitchen appeared to be clean at this time and the appliances and fixtures functional during the time of visit. LPs observed a sufficient amount of perishable and non-perishable food at the facility; properly stored. Sharp objects are to be stored in a locked cabinet above the washer and dryer in the laundry area right next to the kitchen. No Cleaning supplies and toxins were observed in this area at this tie. To the right of the kitchen was the office area and dining room. Dining furniture in kitchen and dining room area appeared to be clean and sufficient at this time.

Bedrooms: The resident bedrooms were properly furnished with a bed, night stand, and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets. LPA observed a sufficient supply of linen and personal hygiene supplies in the hallway closet right outside of Clients' room #2.