Facility Evaluation Report

On 11/12/23 at 8:52 am, Licensing Program Analyst (LPA) Zina Brown conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with the Ericka Jimenez and the purpose of today’s visit was explained. The facility is licensed to operate for (72) ambulatory, (2) non-ambulatory,18 through 59 years of age. Currently the home has (67) clients. The clients are (1) Harbor Regional Center/ Social Security) residents. None the clients have Restricted Health Care Conditions and none are utilizing postural supports or protective devices. The facility fees balance is at $0 and there is a active surety bond. The liability insurance is current and expires 03/04/2025.

The facility is a two story building located in a residential neighborhood. The property consists of the following: 16 apartments (3 bedrooms each with 1 resident who has their own individual room and 2 clients to each room for room 2 and room 3) a living room with chairs and or couches. The common areas include a staff office, kitchen with a dining room and pantry room (with 4 refrigerators and can goods), attached garage, 2 laundry rooms( with washer, dryer and extra linen), a rec room and an outdoor shaded area.

LPA conducted a records review of (10) client records, (10) staff records, (10) clients Personal & Incidental Records and reviewed the facility disaster plan. All client & Staff records were complete. The facility disaster plan was current and in compliance with Title 22 at the time of visit. LPA reviewed (10) Client Medication Administration Records and did not observed any discrepancies at the time of visit.

At 9:05am LPA Brown and Ericka Jimenez toured the inside and outside of the facility. All client rooms were checked. Mattresses and box springs were in good condition, adequate lighting was observed, plenty of dresser and closet space was observed. Walls and floors were clean and in good repair. Bed linens, comforters and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulation. Toilets and water faucets worked properly. Shower was free of mold/mildew, there is adequate lighting, and sufficient toiletries accessible to clients. The water temperature properly measured between 105-120F (in Apt. 2 - bathroom #120.7F, in Apt. 3 - bathroom #2 122.6 F, kitchen - 119.1 F).