Facility Evaluation Report

Licensing Program Analyst (LPA) Erik Zaragoza conducted an unannounced Required 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA explained the purpose of the visit to Secretary Christina Baraza, and Licensee/Administrator Lakecia Higginbotham arrived shortly afterwards. There are no clients who are currently living in the home. The administrator is attempting to obtain clients who are Medi-Cal recipients and is actively attempting to obtain clients.

The following 11 (CARE) tool domains were observed and reviewed: Infection Control, Physical Plant/Environment Safety, Operational Requirements, Staffing, Personnel Records/Staff Training, Client Rights/Information, Client Records/Incident Reports, Food Service, Health Related Services, Incident Medical and Dental, Disaster Preparedness.

· Infection control practices and Personal Protective Equipment (PPEs) were observed. The Facility administrator Lakecia Higginbotham advised that she will be emailing LPA her infection control plan within 7 days.

· The facility is a two-story home located in a residential neighborhood that is licensed for a capacity of six (6) ambulatory clients. It consists of 3 shared client bedrooms, an office for staff, a living room, dining room, a kitchen, three (3) shared client bathrooms of which the first restroom located on the first floor R#1 measured at 115.5 degrees, the second restroom on the second floor next to the laundry area R#2 Measured 113.3 degrees F, and the third restroom connected with the upstairs activity room R#3 measured 106.7 degrees F, a front yard area, and an attached garage in the front yard.