Facility Evaluation Report

Licensing Program Analysts (LPAs) Bennette Pena and Danile Konishi conducted an unannounced Required 1-yr visit. Upon arrival at 1:55pm, LPAs knocked at the door but no one answered. LPA contacted Saundra Sahagun on the phone and arrived shortly thereafter. At 2:45pm, Nicole Snyder arrived to assist LPAs with the inspection. The facility is licensed to care for (4) Developmentally Disabled Adults, ages 18 through 59, non-ambulatory only. All clients residing at this facility receive case management services provided by Frank D. Lanterman Regional Center. LPAs utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. The facility has submitted a COVID-19 Mitigation Plan and Infection Control Plan. Staff are adhering to infection control requirements.

Physical Pl ant/Environment Safety: The facility is a single storey home located in a residential neighborhood, contains four (4) client bedrooms, two (2) full bathrooms, a living room with fireplace, kitchen, dining area, backyard and a detached garage. Currently, there are three (3) clients living in the facility. The interior and exterior physical plant was inspected. Client bedrooms were toured. Each bedroom has a smoke detector, bed, linen, dresser, night stand, light, chair and sufficient closet space. Bathrooms have non-skid materials and contained hygiene supplies including liquid soap and toilet paper. Exit doors are free of any obstruction. Backyard was inspected and there were no debris or any obstructions. There is one (1) fire extinguisher observed to be fully charged, last serviced on 6/14/2023 and mounted on the wall in the kitchen area. Smoke alarms were tested and operable. There are no firearms or weapons stored at the facility. There is no swimming pool or body of water observed. Detached garage was inspected and LPAs observed additional PPE supplies and extra food supplies in the refrigerator. Laundry area is in the detached garage. Facility has a video camera monitor system without audio in the front yard and back yard. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. Water supply measured at 117.3 deg F in bathroom #1, and 114.2 deg F in bathroom #2.

Operational Requirements: A current Plan of Operation was reviewed. A fire clearance is in place. Surety Bond is in effect and in force with bond amount of $6000. Liability Insurance is in place and valid. Emergency drill with staff was last conducted on 4/12/2024.