Facility Evaluation Report

Licensing Program Analysts (LPAs) Daniel Konishi and Christine Wong conducted an unannounced Annual Required Visit on 07/16/2024. LPAs were met by Staff #1 (S1) and explained the purpose of the visit. S1 assisted in tour of facility. Administrator Juanito Paguio arrived shortly after to the facility. The facility has a fire clearance approved for four (4) ambulatory and (1) one non-ambulatory clients. All clients receive services from Harbor Regional Center. LPAs requested and obtained a copy of Personnel Report, and Resident Roster.

The following 12 (CARE) tool domains were observed and reviewed: Infection Control, Physical Plant/Environment Safety, Operational Requirements, Staffing, Personnel Records/Staff Training, Client Rights/Information, Client Records/Incident Reports, Food Service, Health Related Services, Incident Medical and Dental, Disaster Preparedness, and Emergency Intervention.

· Infection control practices and Personal Protective Equipment (PPEs) were observed. LPA observed that the facility has no infection control plan in place.

· LPA conducted a tour of the facility with S1, DSPs and observed the following: The facility is a single-story building in a residential area, with a kitchen, dining room, living room, family room, 4 client bedrooms, 1 live in staff bedroom, 2 bathrooms, backyard with shaded area and a detached garage.

· All passageways, walkways, driveway, steps and patio are free from obstructions. The front, back and side areas of the house are free of hazards.

· Hallway linen closet: Contained plenty of linens, towels, and hygiene products.