Facility Evaluation Report

On 11/02/23, Licensing Program Analyst (LPA) Villegas conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with House manager Policronio Domingo Jr . and explained the purpose of today’s visit. The facility is licensed for 18 developmentally disabled adult clients, current census is 18.

The facility is a single-story structure located in a residential neighborhood and consists of the following: (11) client bedrooms, (2) client bathrooms, meeting area/ dining room, kitchen/medication room, 1 staff bedroom, 1 staff restroom, washer and dryer room, and a two sided shaded porch area. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Toxins and knifes were observed to be stored and inaccessible to clients. There are no bodies of water nor firearms on the property, exits and walkways are free of debris/hazards.

LPA conducted a records review of 2 staff records, 2 client records, and 2 medication administration record. No discrepancies observed. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked. The last fire was conducted on 10/05/23, 3 fire extinguisher fully charged, facility has 2 Carbon monoxide detectors and 20 smoke detectors that are hard wired and interconnected and are working properly. Long Beach fire department checked fire alarm on October 2023. Landline and surety bond observed.

During today’s visit no discrepancies were observed.

Exit interview conducted with House manager Policronio Domingo Jr . , and a copy of this report was provided.