Facility Evaluation Report

Licensing Program Analyst (LPA), Mayra Cota, conducted an announced annual visit today. LPA met with Monique Jordan, Administrator, and the reason for the visit was explained.

The facility is licensed to serve (6) developmentally disabled, ambulatory only adults ages 18 to 59. There are currently no clients living in the home. The two-story home is in a residential area of Pasadena. The first floor consists of living room, dining room, office, kitchen, laundry room, (2) client bedrooms and (1) full bathroom. The second floor consists of (2) client bedrooms, (1) full bathroom and an activity room. The home also has a front and backyard, and a detached garage. LPA Cota, observed the following during today’s visit:

· The building is in good repair inside and outside. All passageways, walkways, stairs and exits are free of debris and obstructions.

· The kitchen is kept clean and the appliances are also kept clean and operable.

· Client bedrooms have the required furniture, bedding and sufficient lighting. Closets have sufficient storage space. Extra bedding was observed in linen closet in the hallway.

· Bathrooms were observed clean and sanitary. Showers have safety grab bars and anti-slip mats. Water temperature measured within 105 – 120 degrees F. (compliance range).

· A fire extinguisher is kept on each floor of the home. Both were observed to be charged and operational.

· Smoke and carbon monoxide detectors were tested and observed to be working properly.

· No client medication is present at the facility.

· Two staff and six client files contain the required documents.

· Emergency and Disaster Plan and Infection Control Plan meet the regulatory requirements.

No deficiencies noted during today’s visit. Exit interview conducted with Monique Jordan, Administrator, and a copy of this report was provided.