Facility Evaluation Report

A One (1) year Required visit was conducted today by Licensing Program Analyst (LPA) Gary Tan. LPA met with the licensee Fatumah Nassanga and purpose of visit was stated. This facility is a North Los Angeles Regional vendored facility Level IV-G.

At 8:43 AM, A tour of the physical plant was conducted with Ms. Nassanga and the following was noted:

The main door is the only entrance being utilized for entry. There is a sign on the door that everyone entering at the facility must wear mask and must be screened. Screening area is located immediately before entrance. Sign in sheet, hand sanitizer, gloves and masks are available.

The facility had submitted and approved Mitigation and Infection plan.

Signs to wear a mask and other Covid 19 prevention protocol signs were posted on the walls. 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 back.

Facility has four (4) client bedrooms and one and a half (1 1/2) bathrooms. There is a section in the house dedicated for staff use. There are three (3) staff bedroom, a bathroom and a small kitchen inside the section. The staff section was observed to locked during visit. There is no body water in the facility.

Bedrooms were toured and observed to be clean and properly furnished. Linen storage was also checked and observed to have sufficient supply of clean linen and towels.

Bathrooms were observed to be clean and sanitary with necessary supplies. Hot water temperature measured at a range of 109.1°F to 109.5°F and within the required range. (continued on LIC 809-C)