Facility Evaluation Report

Licensing Program Analyst (LPA) Mayra Cota conducted an unannounced required annual inspection with Sky Julian, Administrator who facilitated the visit. The reason for the visit was explained.

The facility is licensed to serve (3) ambulatory and (1) non-Ambulatory developmentally disabled adults, ages 18 through 59. Facility currently has 3 ambulatory clients serviced by Harbor Regional Center. The facility is operating within the scope of its license. The facility is in a residential area of Lakewood, CA.

During the visit, LPA toured the facility's indoor and outdoor environment, reviewed (3) client and (5) staff files and conducted medication review for (3) clients. The facility is a single-story house which consists of: living room/computer area, dining room, kitchen, (2) full bathrooms, (4) client bedrooms, laundry room, front and backyard, deck/patio area and detached garage.

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.

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

Sharps were observed locked in the garage and are inaccessible to clients.

Sufficient supply of 2 day perishable and 7 day non-perishable food was observed. ***Continues on LIC 809C .