Facility Evaluation Report

Licensing Program Analysts (LPA) Elena Mallett arrived at the facility to conduct an unannounced Annual visit . LPA met with Staff Ryan and the purpose of the visit was explained. Administrator Renee Davenport joined the visit shortly after. The facility is licensed to serve three (3) non- ambulatory clients between the ages of 18 through 59.

The facility is a single-story home, located in a residential area of Lakewood that consists of a living room, dining area, a kitchen, three (3) client bedrooms, (2) bathrooms, an attached garage, a front yard and a backyard with a covered shaded area with seating.

LPA completed the visit using Compliance and Regulatory Enforcement Tools (CARE) . The following domains were completed during the visit

Infection Control: Infection Control Plan was reviewed by LPA. Facility follows title 22 regulations and is cleaning and disinfecting regularly. Staff has PPE and practices hand hygiene.

Physical Plant and Environmental Safety: Physical plant is clean and sanitary and the hallways and walkways are free from debris and obstruction. Hot water temperature measured within Title 22 regulations in both bathrooms. Facility has combination smoke and carbon monoxide detectors that were tested and operational. A fully charged fire extinguisher was present near the kitchen. Sharps and toxins are locked in cabinets. Client bedrooms required light and furnishings. Extra linens and blankets were observed. A mattress in one of the client’s bedrooms was observed to be stained. A deficiency was cited. See 809-D