Facility Evaluation Report

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Required- 1 year visit. LPA met with Gabriela Rivera, Direct Support Professional II (DSP II) and Alma Gutierrez, Direct Support Professional II (DSP II) and explain ed the purpose of the visit. At 1:30pm, Lawrence Droughn, Administrator arrived and assisted LPA. The facility is licensed to care for (4) ambulatory and (1) non ambulatory Developmentally Disabled Adults, ages 18 through 59. All clients residing at this facility receive case management services provided by Frank D. Lanterman Regional Center. LPA inspected the facility using the Compliance and Regulatory Enforcement (CARE) tool and observed the following:

Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. There is a visitor sign-in station located near the front door. Staff are adhering to infection control requirements. The facility has submitted the Infection Control Plan.

Operational Requirements: A current Plan of Operation was reviewed. The Infection Control Plan was submitted to CCL and added to the Plan of Operation. Surety Bond is in effect with bond amount of $8000 and expires on 05/20/2025 . Fire/Disaster Drill was last conducted on 10/28/2024.

Physical Plant/Environment Safety: The facility is a single story home located in a residential neighborhood, contains (3) client bedrooms, (1) bathroom, living room, kitchen, dining room, backyard, and detached garage. Currently, there are (5) clients living in the facility. Facility is a Level 4I . The interior and exterior physical plant was inspected. Client bedrooms were toured. Bathroom has non-skid materials and contained hygiene supplies including liquid soap, paper towels, and toilet paper. Exit doors are free of any obstruction and there are no pools or large bodies of water. Backyard was inspected and observed shaded ar ea with patio furniture. LPA also observed a lot of debris, dried leaves, fallen branches and broken fence in the backyard. Kitchen knives, sharps objects, are kept locked in a locked cabinet in the kitchen area and inaccessible to clients. LPA observed a fire extinguisher on the kitchen floor without a tag and no receipt found on file. Smoke alarms and carbon monoxide were tested and operable. There are no firearms or weapons stored at the facility. Water t emperature reading in bathroom #1 was 92.1 deg F which was not within the required 105-120 degrees Fahrenheit. *****CONTINUED ON LIC809-C*****