Facility Evaluation Report

Licensing Program Analyst (LPA) Christian Gutierrez conducted the annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA met with John Fernandez (caregiver) and explained reason for visit. Administrator Maria Tavarez was notified over the telephone.

The facility is licensed to serve 4 non-ambulatory residents ages 60 and above, with a hospice waver for two. The facility currently has 4 residents all serviced through Harbor Regional Center, none of the residents are currently using hospice service.The facility is a single-story home located in Lakewood, Ca. A tour of the facility included: living room, dining area, kitchen, 4 resident bedrooms, 2 resident bathrooms, 1 staff bedroom with private bathroom, laundry area, attached garage, front yard and backyard.

LPA toured the facility and observed the following: Each resident’s bedroom has the required bedding and furniture. There is extra clean linen and towels in hallway closet. Smoke detectors and carbon monoxide detectors were observed in each room and throughout the facility and are properly operating. The facility has two (2) fully charged fire extinguishers. Cleaning supplies, toxic substances, and sharps are inaccessible to clients in a locked cabinet under kitchen sink. Freezers are maintained at a temperature of 0-degree F and the refrigerators at a maximum of 40 degrees F. Sufficient supply of 2 days perishable & 7 days non-perishable foods was observed in the kitchen. There are cleaning supplies, hygiene products, and emergency food in garage. There are no firearms or weapons stored at the facility. The hot water temperature in the bathrooms were measured between the required range of 105-120 degrees F. The facility does not have a swimming pool or bodies of water on the premises There is a shaded seating area for the residents located in the backyard. Passageways and exits are free of obstruction.