Facility Evaluation Report

Licensing Program Analyst (LPA) Luis Mora conducted an unannounced annual visit using the CARE Tool. LPA met with Andrew Thomas (Direct Support Specialist) and explained the reason for the visit. The facility is licensed to serve 4 developmentally disabled adults ages 18 to 59 years old and one non-ambulatory. The facility is operating within the scope of its license.

LPA and Andrew toured the home and inspected 4 client bedrooms, 2 bathrooms, kitchen, dining area, laundry area, living room, front yard, backyard, and attached garage. The front and backyard are well maintained and there are no pools or large bodies of water. There is a shaded seating area for the clients located in the backyard. Passageways and exits are free of obstruction. The water temperature was tested in both bathrooms and measured at 107.8 degrees F and 106.8 degrees F which are within the required 105 - 120 degrees. Client bedrooms have the required furniture such as bed frames, dressers, lamps and chairs. Bedrooms also have sufficient closet space. Client beds have the required linen and the linen is in good condition. There is a cabinet in the laundry area with clean towels. Each client has extra clean linen in their closet. Smoke detectors were observed in each room and throughout the facility, and are properly operating. There is a carbon monoxide in the living room and it is properly operating. There is one fire extinguisher located in the kitchen which is fully charged. Kitchen appliances are clean and were operating at the time of the visit. Sharps are locked in a laundry area cabinet and are inaccessible to clients. Cleaning supplies and toxins are locked in a laundry area cabinet and are inaccessible to clients. First Aid kit was fully stocked with current manual and it is kept locked in the medication cabinet. Sufficient supply of 2 days perishable & 7 days non-perishable foods were observed in the kitchen. Client medications and files are centrally stored in a locked closet in the hallway. Staff files are kept locked in the garage. All three of the client files and medications were reviewed. Medications are documented properly and given as prescribed. Five staff files were reviewed.. LPA interviewed 2 staff and could not interview any of the clients due to the clients being non-verbal.

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.