Facility Evaluation Report

Licensing Program Analyst (LPA) Mora conducted an announced annual visit using the CARE Tool. LPA met with Eliezer Garcia (Direct Support Professional) and explained the reason for the visit. Facility is licensed to serve 4 ambulatory only clients in the age range of 18 through 59.

A tour of the single-story facility included the 4 client bedrooms, 2 bathrooms, living room, dining area, kitchen, laundry room, front yard, backyard and attached garage. LPA conducted the tour with Eliezer 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 and cleaning solutions are kept locked in a laundry room cabinet. Medications are kept locked in a separate laundry room cabinet. Client and staff files are kept in the medication cabinet. The First Aid kit is kept locked in 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 cabinets. Dining and living room have sufficient lighting and sitting area. All bedrooms have all required furniture, lighting, and bedding. All showers were observed with non-skid material. The water temperature was tested in both bathrooms and measured at 114.1 degrees F and 108.7 degrees F, which is within the required 105-120 degrees F. Fire extinguishers were observed in the kitchen, hallway, and laundry room, and are is fully charged. Smoke detectors were observed throughout the facility and in each room and were operable during the visit. A carbon monoxide was observed 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. LPA reviewed 4 client and 5 staff files. LPA reviewed 4 client medications. Medications are documented properly and given as prescribed. LPA interviewed 1 staff and 2 clients.

Per California Code of Regulations, Title 22, and California Health and Safety Code, there were no deficiencies observed during the visit. Exit interview held and a copy of the report was provided.