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 Kyra Richards who is the administrator of the facility and was granted access into the home. There are four (4) ambulatory developmentally disabled clients who reside in the home. The facility is vendored through the South Central Los Angeles Regional Center.

The following 12 (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, and Emergency Intervention.

· Infection control practices and Personal Protective Equipment (PPEs) were observed. LPA advised administrator to submit an Infection Control Plan to us within 7 calendar days.

· The facility is a single-story home located in a residential neighborhood that is licensed for a capacity of four (4) ambulatory clients. It consists of four (4) private client bedrooms, a living room, a dining room, a kitchen, a shared bathroom whose hot water temperature measured at 1184 degrees F, a front yard area, a back patio area which held the washing and drying machines for doing the client’s laundry, and a separate detached garage.

· The interior and exterior physical plant was inspected. Exit doors are free of any obstruction and there are no pools or large bodies of water. Smoke and carbon monoxide detectors are operational. The facility has one (1) fully charged fire extinguishers which is kept in the kitchen. Cleaning supplies and toxic substances are inaccessible to clients in a locked storage area next to the entrance of the facility.