Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the annual inspection with the focus of the Infection Control domain. LPA met with the Administrator, Memer Dellosa, who assisted with the inspection. The facility is licensed to serve four (4) developmentally disabled adults ages 18 - 59 and approved for 4 non-ambulatory clients. There are currently 3 clients residing at the home and are placed by the Eastern Los Angeles Regional Center. The facility has an approved mitigation plan.

LPA toured the facility with the Administrator and observed the following:

The facility has 5 bedrooms (4 client bedrooms and 1 staff bedroom), 3 bathrooms, living room, kitchen with laundry area, dining room, second living room, and a detached garage. Client have their own room and are able to quarantine in the room if needed. The backyard has a shaded patio for clients use. The facility is well maintained with no items obstructing the passageways. LPA observed Coronavirus (COVID-19) signage throughout the facility to promote hand washing hygiene, cough/sneeze etiquette, and symptom checks. The facility has at least 30 days of PPE supplies in storage. Food supplies for 2 day perishable and a week of non-perishable are also observed. Knives, cleaning solutions, and disinfectants are stored and locked making them inaccessible to clients. Smoke detectors and a carbon monoxide detector were tested and operable. The fire extinguishers were last inspected on 9/28/21. Medications are centrally stored and locked in the kitchen cabinet. LPA reviewed all 3 clients' medications and staff are administering them as prescribed. The facility is continuing to follow the COVID-19 mitigation plan.

No deficiencies were observed during the visit today. An exit interview was conducted and a copy of this report was provided.