Facility Evaluation Report

Licensing Program Analyst (LPA) Luis Mora conducted an unannounced annual visit at the facility with focus on the infection control domain, medication and food review. LPA Mora met with Administrator Luz Rasco and explained the reason for the visit. The facility is licensed to serve one non-ambulatory and three ambulatory clients ages 18-59. Facility currently has 1 non-ambulatory and 1 ambulatory client serviced by Harbor Regional Center.

The facility is in a residential area and it is a one story family home. A tour of the single-story facility included the living room, dining room, kitchen, 4 client bedrooms, 2 client bathrooms, laundry area, front yard, backyard, and detached garage/office room.

LPA Mora conducted the tour with Luz Rasco and observed the following: sufficient food supplies for at least 2 days of perishables and 7 days of non-perishables were observed in the kitchen. Sharps were observed locked in a kitchen cabinet. Chemical and cleaning solutions are kept locked in a cabinet above the washer and dryer and also under the kitchen sink. The First Aid kit is kept above the medication cabinet and it is fully stocked with all required items including a current manual. Clean towels and extra clean linen were observed in the hallway cabinet. Dining and living room have sufficient lighting and sitting area. Medications are kept locked in a cabinet near the kitchen. Client and staff files are kept in the garage/office room. All bedrooms have all required furniture, lighting, and bedding. All bathrooms were observed with shower mats. The water temperature was tested in both bathrooms and measured at 113.3 degrees F and 1116.7 degrees F, which is within the required 105-120 degrees F. A fire extinguisher was observed in the kitchen and it is fully charged. Smoke detectors were observed throughout the facility and in each room and were operable during the visit. There is one carbon monoxide located in the kitchen and was operable during the visit. The front yard and backyard are clean. There is a shaded area with seating in the backyard. No bodies of water were observed at the facility. Passageways and exits are free of obstruction.