Facility Evaluation Report

Licensing Program Analyst (LPA) Daniel Konishi 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 S1 (Staff #1) and was granted entrance to the facility . Administrator, Robert Neal arrived shortly thereafter. There are three (3) 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.

· The facility is a single-story home located in a residential neighborhood that is licensed for a capacity of four (4) ambulatory developmentally disabled clients between the ages of 18-59. It consists of three (3) shared client bedrooms, a living room, dining room, a kitchen, one (1) shared client bedroom, a shared client restroom whose hot water temperature measured at 102.2 Degrees F, a front and back patio area, and a laundry room.

· 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. Carbon Monoxide Detector was tested and operational. The facility has one (1) fully charged fire extinguisher that are kept in the kitchen of the facility and one (1) fully charged fire extinguisher in the dining room.