Facility Evaluation Report

Licensing Program Analyst (LPA) Jose Villalobos conducted an unannounced Annual inspection focused on domains within the Compliance and Regulatory Enforcement (Care) Tools. LPA was met by Staff Cassandra McCoy and the purpose of the visit was explained. Administrator Maria Drummond arrived shortly after.

Physical Plant: The facility is a single story house and located in a residential neighborhood. The home is vendorized through the Harbor Regional Center (HRC). It is licensed to serve four developmentally disabled, adult clients ages 18-59, of which four (4) can be non-ambulatory. The facility consists of four (4) client bedrooms, three (3) bathrooms, kitchen, laundry area, dining room and an attached garage. Client bedrooms are for (1) client each and have required furniture per Title 22. The bathrooms observed are clean and operational. The hot water temperature in the two bathrooms was measured within title 22 regulations. The food supply in the kitchen and pantry has at least two days perishable and seven days non perishable food. The front and back yard are free of debris and obstructions. The back yard has shaded area with for client use. All the appliances are clean and working properly. The common areas such as living room and dining room are clean and have the required furniture. The smoke detectors and carbon monoxide detectors were observed and operational. MEDICATION: Medications are stored, locked and inaccessible to clients. POSTINGS: All necessary postings were observed to be posted in appropriate places. A current Plan of Operations, Infection Control Plan, and Disaster plan is maintained at the facility. Operating telephone was observed and available for resident use. RECORD REVIEW: LPA reviewed four (4) client files, four(4) client medications, and four (4) staff files.

Visit completed with Inspection Tool and no deficiencies are being cited on todays visit. Exit interview conducted with Administrator Maria and a copy of this report was provided.