Facility Evaluation Report

On 07/21/2023 Licensing Program Analyst (LPA) Evelin Rios arrived at the facility above to conducted a Case Management - Legal/Non-compliance visit and inspection of the facility to ensure facility compliance. LPA met with Administrator Jessica Hernandez and explained the reason for the visit. On January 17, 2023, a Non-Compliance Conference (NCC) was held at the Woodland Hills Regional office. As a result of that NCC, the facility was placed on a two year compliance plan.

At approximately 11:00 a.m., LPA and administrator took a tour of the physical plant. The smoke/carbon detectors are hardwired and interconnected and observed to be functioning properly.

Kitchen: LPA observed staff #1 (S1) working on laundry. The kitchen was clean and clear of clutter. LPA observed a two day supply of perishable and a seven day supply of non-perishable food at the facility; properly stored. LPA observed sharps or knives properly stored in a locked kitchen cabinet inaccessible to clients in care. Properly labeled medications were locked in one of the kitchen cabinets. The fire extinguisher is in the kitchen, was observed fully charged with last service date 10/19/2022.

Bedrooms: There are five (5) bedrooms four (4) of which are designated for client use. All the bedrooms were properly furnished with appropriate beddings, linens and sufficient lighting.

Bathrooms: There are two (2) bathrooms one (1) of which is designated for resident use. Bathrooms were properly supplied with paper towels, hand soap and had functional fixtures. Hot water temperature was measured at 117.6 degrees Fahrenheit. Extra toiletries and bathroom supplies are stored in the staff bathroom.

Common Areas : These included the living room and dining area. The common areas were properly furnished. Dining room and the living room are furnished with appropriate seating to comfortably sit the capacity of the facility. (LIC809 Continued on next page)