Facility Evaluation Report

A Required One (1) year visit was conducted today by Licensing Program Analyst (LPA) Gary Tan. LPA met with Kumbirai Zvatta (Peter), alternate Administrator and purpose of the visit stated. LPA observed that the two (2) residents were at the facility during visit and the other was picked up by family. This facility is a North Los Angeles Regional Center (NLARC) vendored facility Level III.

A tour of the physical plant was conducted at 12:24 PM and the following was noted:

The front main door is the only entrance being utilized at the facility. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available. The facility had submitted approved Mitigation and Infection Plan.

Signs to wear a mask and other Covid 19 prevention protocol signs were posted outside the doors. Hand washing, coughing etiquette, physical distancing, and other necessary signs were posted in the bathroom and all over the facility. All trash cans were observed to be with cover.

The facility has a designated visitors' area at the backyard and the office converted garage. The facility has sufficient stock of PPE in the garage.

The facility is a single storey house and has four (4) bedrooms and two (2) bathrooms. One (1) bedroom and one (1) bathroom is designated for staff use. There is no body water in the facility. The facility is fire cleared for four (4) ambulatory residents.