Facility Evaluation Report

Licensing Program Analyst (LPA) S Vaid conducted a site visit for the annual inspection. Upon arriving at the facility LPA met with Johnette Bellosillo (Licensee) and explained the purpose of the visit. Licensed to serve four (4) developmentally disabled adults; three (3) can be non-ambulatory. Todays census is three (3) clients. Clients are Harbor Regional Center.

The facility is located in a residential area. A tour of the single-story facility includes: Living room, kitchen, dining area, 4 client bedrooms, 1 staff room, 2 bathrooms and an attached garage.

During today’s visit, LPA utilized the Compliance and Regulatory Enforcement tool. Interviewed two (2) staff and two (2) clients, third client was at day program and was not interviewed. Reviewed three staff (3) files no issues observed. Reviewed three (3) client files, no issues were observed.

I nfection Control: The facility staff are using appropriate hand hygiene and gloves 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: There are 4 client bedrooms, 2 bathrooms 1 staff room/office, living room, dining area, kitchen, attached garage with laundry, front yard, and backyard. Bathrooms are clean and operational. Clients’ bedrooms were checked and furnishings are one bed, night stand, sitting chair, lamp. The backyard is free of debris/hazards and the outdoor and passageways are free of obstruction. No bodies of water were observed at the facility and there are no weapons on the premises. Hygiene products are readily available and stored in a storage closet. The hot water temperature was tested in all bathrooms and the kitchen was measured within the required range of 105-120 degrees F. All storage areas for cleaning solutions, toxins, knives, and hazardous items are stored in a secured/locked area in the kitchen and inaccessible to clients. The last Fire/Emergency Drill was conducted on 02/18/2024 . Smoke detectors and carbon monoxide detectors are operable and in compliance. The fire extinguisher was observed and is fully charged and was last serviced on 04/18/2024.