Facility Evaluation Report

Licensing Program Analyst (LPA), Mayra Cota, conducted an unannounced annual visit today, using the CARE Tool. LPA met with Bertha Duarte, Direct Support Staff and Administrator Ronald Bautista arrived thereafter and assisted with the tour of the facility. The reason for the visit was explained. The physical plant was inspected along with client and staff records, food supply and medication. The facility is licensed to serve 2 non-ambulatory and 2 ambulatory clients in the age range of 18 through 59. Clients receive services through Harbor Regional Center. The facility is operating within the scope of its license. Currently, the facility provides services to three clients. One client was present during the visit and two clients were away at day program. The facility is a single home, located within a residential neighborhood.

LPA observed the following during today's visit:

The home is made up of four client bedrooms, two bathrooms, living room, staff office space, kitchen and dining area. Client bedrooms (four) have the required furniture such as bed frames, dressers, adequate lighting, and chairs. Bedrooms also have sufficient closet space. Beds have the required linen, and linen is in good condition. Extra linen and personal hygiene supplies were observed in hallway closet. The water temperature in both bathrooms was tested and observed to be 105 - 105.7 degrees F which is within the required regulation of 105 - 120 degrees F. The living room furniture is clean and in good repair. Exercise equipment was observed in the living room, operable and accessible to clients. The kitchen was observed to be clean and for the ability to prepare and serve food. Appliances in the kitchen were clean and functional. The pantry was stocked with sufficient food and labeled for use within expiration limits. Sufficient supply of 2 days perishable & 7 days non-perishable food was observed in the kitchen and in the garage overflow refrigerator. Sharps and cleaning supplies were observed to be locked in a kitchen cabinet and inaccessible to clients. Attached garage is kept locked. The garage houses a laundry area which is equipped with one washer and one dryer. Both appliances were operable during visit. Laundry liquids are kept locked in garage storage cabinet.