Facility Evaluation Report

Licensing Program Analyst (LPA) Tao conducted an unannounced annual visit at the facility using the CARE inspection tool. Upon arrival, LPA met with Staff#2 (S2) house manager Lerisa Cantos. The reason for the visit was explained to them.

The facility is licensed to serve eight (8) mentally disabled adults, ambulatory only, ages 18-59. Annual fees are current. The facility is a two-story home located in a residential area in Pasadena. The facility consisted of a living room, dining room, kitchen, four (4) client bedrooms in which three (3) rooms are upstairs and one (1) room is downstairs, two (2) clients’ bathrooms, one (1) staff room/office, one (1) staff bathroom, front yard and back porch with laundry room/area, a shaded outdoor sitting area.

The following CARE tool domains were reviewed during this visit:

Infection Control: Sufficient PPE supplies and an Infection Control Plan maintained at the facility were observed and in compliance.

Physical Plant & Environment Safety: Physical plant tour was conducted. Clients’ bedrooms were checked and in compliance. The backyard, outdoor and passageways were free of hazards. Hygiene products were readily available for clients. All storage areas for cleaning solutions, toxins, knives, and hazardous items were locked and were inaccessible to clients. Water temperature was measured and were between 105.0 to 105.1 degrees F., which were in compliance with regulations. Smoke detectors and carbon monoxide detectors were operable. Fire extinguishers were fully charged. (-Continued on the LIC809-C)