Facility Evaluation Report

:Licensing Program Analyst conducted an unannounced annual inspection visit focusing on infection control. LPA was allowed entry to this home by Staff Bemar Mondiagon DSP, and Administrator Edith Silva arrive a short time later. Last fire drill was on 8/16/2022 and Administrator certificate expires on 11/30/2022.

This home is for Developmentally Disabled individuals ages 18 to 59. The (4) Clients residing at this home receive case management services provided by Harbor Regional Center. This is a single-story home with 4 bedrooms 3 bathrooms, living room, kitchen, dining area and an attached garage. Licensing annual fees are current.

· COVID-19 signs are posted at the entrance. Visitors are screened in the main entrance and a log is kept

· Infection control signs and other COVID-19 signs are posted throughout the facility in the bathrooms, kitchen, and hallway to promote handwashing, cough/sneeze etiquette, and physical distancing.

· Facility does not has one designated isolation room as all rooms are private.

· Four client rooms, common areas, bathrooms, and outdoor physical plant was inspected.

· Client rooms were not equipped with alcohol-based hand sanitizer but available throughout facility.

· Four (4) centrally stored client medication records were reviewed.

· Staff responsible for direct care and supervision were observed wearing masks.

· Clients were not observed wearing masks but adhering to public health social distance guidelines.

· Sufficient supply of perishable for 2 days & non-perishable foods for 7 days were observed.

Deficiencies cited, please see 809D for details.

Exit interview conducted with staff Edith Silva and copy of report provided.