Facility Evaluation Report

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Required-1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA was met by Ben Robertson/Staff, Jean Roberston/Staff and Bernadette Stephenson, Licensee/Administrator and explained the purpose of the visit. The facility is licensed to care for (4) Developmentally Disabled Adults, non-ambulatory, ages 18 thr ough 59. There's zero (0) clients in the facility during the visit. Licensee/Administrator stated that she is in the process of applying vendorization from Frank D. Lanterman Regional Center.

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 maintained. None of the staff were wearing masks and staff are aware to use disposable gloves to clean and disinfect the high touched surfaces in the common areas. The facility has submitted a COVID-19 Mitigation Plan and Infection Control Plan. COVID-19 signs are posted in the facility. Bathrooms have hand washing signs, soap and paper towels. Staff are adhering to infection control requirements.

Physical Plant/Environment Safety: The facility is a single storey home located in a residential neighborhood, contains a total of (3) client bedrooms, (1) bathroom, a living room, kitchen, dining area, backyard, and a detached garage. Currently, there are no 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, light, chair and sufficient closet space. Bathrooms have 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 LPA observed a locked small shed used as a storage. LPA also observed a small dwelling unit in the back which is being occupied by (2) staff only. LPA also observed miscellaneous items in the side yard which was cleaned up during the visit. Detached garage was also inspected. Kitchen knives, sharps objects, cleaning supplies and toxic substances are locked and inaccessible to clients. There is a fire extinguisher mounted on the kitchen wall observed to be fully charged. Smoke alarms and carbon monoxide were tested and operable. There are no firearms or weapons stored at the facility. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. At 10:25am, hot water supply measured 116.3 in bathroom #1.

Operational Requirements: A current Plan of Operation was reviewed. The Infection Control Plan has been submitted to CCL. A fire clearance for (4) clients is in place. Liability Insurance policy in the amount of $1,000,000.00 each occurrence and $3,000,000.00 in the total annual aggregate is valid and will expire on 11/28/2024. Surety Bond (Western Surety Company) is valid with bond amount of $6000. Last Fire and Earthquake Drills were conducted on 11/15/2023 and drills with staff are to be conducted on a quarterly basis.