Facility Evaluation Report

Licensing Program Analyst (LPA), Mayra Cota, conducted an unannounced required annual visit. LPA met with Mercedes Dominguez, Caregiver, and explained the reason for the visit. Administrator, Jessica Diaz, arrived thereafter and assisted with the visit.

The facility is licensed to serve 4 ambulatory only developmentally disabled adults ages 18 to 59 years old. The facility is operating within the scope of its license. Clients receive services through the Harbor Regional Center. The facility is in a residential area of Lakewood.

During the visit, LPA toured the facility's indoor and outdoor environment, reviewed 4 client and 3 staff files, and conducted medication review. The facility is a single-story house which consists of: living room, dining area, kitchen, office area, two full bathrooms, four bedrooms, front yard and backyard/patio area and attached garage/laundry area.

During today’s visit, LPA observed the following:

Living room furniture is clean and in good repair. There is sufficient seating for clients in care. Activity cabinet was observed to have games and other pastime materials, accessible to clients.

Kitchen appliances are clean and were operating at the time of visit.

Cleaning supplies/toxins were observed locked under kitchen sink and are inaccessible to clients.

Sharps/knives are kept locked in kitchen closet and are inaccessible to clients.