Facility Evaluation Report

An unannounced One (1) Year Required visit was conducted on this day by Licensing Program Analyst (LPA) Jose Tan. LPA met with Licensee Sonny Agbede and explained the purpose of the visit. This is a North LA Regional center vendored facility Level 5.

LPA conducted physical plant tour inside and out at 12:43 PM. During the tour, LPA observed that the facility has four (4) private client bedrooms and three (3) bathrooms. One (1) bathroom is designated for staff use. There is no body of water at the facility.

The front main door is the only entrance being utilized at the facility. The facility had submitted and approved Mitigation and Infection Plan.

Bedrooms were toured and observed to be clean and furnished.

Bathrooms were observed to be clean, sanitary and with necessary supplies. Hot water temperature was measured at 118.6°F.

Physical plant was checked for cleanliness and condition. Facility was observed to be generally in good repair and clean during today's visit.

Living and dining room furniture were also checked for functionality (wear and tear). The furniture were observed to be in good condition. (continued on LIC 809-C)