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 the Lead Staff of the facility Lazarina Estandarte. Administrator Jonathan Tomines was notified of the annual inspection over the phone by the LPA also. There are three (3) ambulatory developmentally disabled clients who reside in the home. The facility is vendored through the East 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. Facility has already completed their Infection Control Plan and emailed it to the LPA during the visit.

· The facility is a single-story home located in a residential neighborhood that is licensed to serve only ambulatory developmentally disabled clients. It consists of one (1) shared client bedroom, a living room, dining room, a kitchen, an office, two (2) private client bedrooms, and two (2) shared client bathrooms of which R#1 which measured at 110.3 Degrees F, and a second shared restroom (R#2) measured at 115.8 Degrees F, a front and back patio area including a shed in the backyard that contains the facility’s cleaning supplies, and an attached garage which contains the facility’s laundry machines.

· 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.