Facility Evaluation Report

A Required One (1) year visit was conducted today by Licensing Program Analyst (LPA) Gary Tan. LPA met with co Administrator Louise McMillon and explained the reason for the visit. This is a North Los Angeles Regional Center vendored facility Level IV-G.

A tour of the physical plant was conducted at 12:12 PM and the following was noted:

The main door is the only entrance being utilized at this facility. Screening area is located immediately after entrance. Sign in sheet, hand sanitizer, gloves and masks are available. The facility had submitted and approved Mitigation and Infection plan.

The facility has a designated visitors' area at the backyard. The facility has sufficient stock of PPE in the storage room.

Facility has three (3) shared client bedrooms and two (2) bathrooms. There is no body water in the facility. The facility is fire cleared for four (4) non-ambulatory residents.

Bedrooms were toured and observed to be clean and properly furnished. Linen storage was also checked and observed to have ample supply of clean linen and towels.

Bathrooms were observed to be clean and sanitary with necessary supplies. Hot water temperature was measured at 116.9°F. (continued on LIC 809-C)