Facility Evaluation Report

Licensing Program Analyst (LPA) Shira Stamps met with Dominic Anderson(Licensee/Applicant) and Miranda Ochoa (Administrator) for a Pre-licensing inspection at 12:50 pm.

The home will be vendored by North Los Angeles Regional Center. The home will serve four (4) level 4 intellectually disabled adults. Clients will be all ambulatory. The facility has four (4) bedrooms and two (2) bathrooms designated for a capacity of four (4) clients. There is no bedroom designated for staff. Staff will be awake at night.

The physical plant was toured inside and out at 12:55 pm.

Common Area: LPA observed the living room and furniture to be clean and in good repair. LPA observed the dining area to be clean and in good repair. The facility maintains a comfortable temperature at 64 degrees F, which meet regulations. The air conditioner is operational. No firearms observed or will be maintained on the premises.

The smoke alarm and carbon monoxide detector were operational and tested at 1:15 pm. The fire extinguisher appear to be full and serviced on 09/09/2021.

Resident room s: Rooms available are all private. LPA observed rooms to have bedding sheets, pillowcase, blankets, mattress pads, which are in good condition. There is at least one chair, a night stand, and sufficient lighting for each client. The mattresses and bedsprings were also checked for condition.

Window covering and window screens are in good repair for each room.

Consumers will have sufficient amounts of supplies for personal hygiene products, which is provided by the Licensee. Continued...