Facility Evaluation Report

Licensing Program Analyst (LPA), Mayra Cota, conducted an unannounced required annual visit. LPA met with Kevin Rodriguez, Caregiver, and explained the reason for the visit. Assistant Administrator, Maria Tavarez, arrived thereafter and assisted with the visit. Ricardo Banos, Administrator, was contacted telephonically and was also informed regarding the reason for the visit.

The facility is licensed to serve 4 non-ambulatory developmentally disabled elderly residents ages (60) and above. Hospice Waiver for (2) residents in place. The facility is operating within the scope of its license. Residents receive services through the Harbor Regional Center.

The facility is in a residential area of Lakewood, CA. During the visit, LPA toured the facility's indoor and outdoor environment and reviewed (4) resident and (3) staff files. Resident medication was also reviewed The facility is a single-story house which consists of: living room, dining area, kitchen, (4) resident bedrooms, (2) bathrooms, office area, activity room, laundry area in the garage, backyard/outdoor patio, and attached garage.

During today’s visit, LPA observed the following:

Facility was observed to be clean and maintained. Walkways around perimeter of facility are clear of obstructions.

Living room furniture is clean and in good repair. There is sufficient seating for residents in care. Fire place was observed to be covered and inaccessible to residents.