Facility Evaluation Report

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Required 1-yr visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA was met by Luis Hernandez, Direct Care Staff I & II (DSP I & II) and explained the purpose of the visit. At 1:15pm, Ernesto Vasquez, Program Director arrived and Saundra Sahagun, Administrator arrived at 1:35pm, both assisted LPA with the inspection. The facility is licensed to care for (4) Developmentally Disabled Adults, ages 18 through 59, non-ambulatory of which (1) ma y be bedridden . All clients residing at this facility receive case management services provid ed by Frank D. Lanterman Regional Cente r . LPA 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. There is a visitor sign-in station located at the entrance on the the side front door. LPA observed a staff using disposable gloves while cleaning and disinfecting the high touched surfaces in the kitch en area. Staff stated they use gloves when handling food and assisting with medication. Staff are adhering to infection control requirements.

Physical Plant/Environment Safety: The facility is a single storey home located in a residential neighborhood, contain s four (4) client bedrooms, two (2) full bathrooms, a living room with fireplace, kitchen, dining area, family room, backyard and a detached garage. Currently, the re are four (4) clients living in the facility. Facility is a Specialized Home. T he 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 are two (2) fire extinguishers observed to be fully charged and mounted on the wall near the front door and 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. Facility has a video camera monitor system in the common areas, front yard and back yard. Water temperatu re readings measured within the required 105 - 120 degrees Fahrenheit. At 1:45pm, water supply measured at 112.6 deg F in bathroom #1, and 114.8 deg F in bathroom #2.

Operational Requirements: A current Plan of Operation was reviewed. Surety Bond is in effect and in force with bond amount of $6000. Fire & earthquake drills with staff were last conducted on 3/17/2024. ****REPORT CONTINUED ON LIC809-C*****