Facility Evaluation Report, 09/26/2023

Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced visit for an Annual Inspection. Upon arrival, LPA met with Dave Mendoza (Caregiver) and explained the purpose for the visit. The facility is licensed to serve 2 Non-Ambulatory Developmentally Disabled Adults Ages 18-59 years old.

The facility is a single-story home located in a residential area in Norwalk, Ca. A tour of the facility includes: 2 Client Bedrooms, 2 Staff Bedrooms, 1 Private Bedroom (see 812), 2 bathrooms (one is inside staff room), Office Area, Living Room, Dining Area, Kitchen, Front Yard, and Attached Garage.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: The facility staff are using appropriate hand hygiene while assisting clients’ medications. Staff are cleaning and disinfecting throughout the day. Facility has sufficient PPE supplies and has an Infection Control Plan.

Physical Plant & Environment Safety: Client bedrooms had the required furniture for comfort and safety and had sufficient lighting. All outdoor passages were free of obstruction. Bathroom was clean, toilet and water faucet worked properly. Water temperature was measured in client bathroom and was within the required range of 105 – 120 Degrees F. Client bath towels, toiletries and personal hygiene supplies were adequately available. All storage areas for cleaning solutions, toxins, knives, and hazardous items are securely stored and inaccessible to clients. Smoke detectors and carbon monoxide detectors are operable and in compliance. The fire extinguisher was observed to be fully charged.

Operational Requirements: The facility has the appropriate fire clearance. The last Fire/Emergency Drill was conducted on 09/01/23. There was no outdoor activity area with required shade and outdoor furnishing (this will be cited on 809-D).

Staffing : There appears to be sufficient staffing at all times in the facility. Administrator Lolita Tan’s certificate expires on 01/17/2024.