Facility Evaluation Report

Licensing Program Analysts (LPA)s Bennette Pena and Daniel Konishi conducted an unannounced Required-1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPAs were met by Maria Carlos, Administrator and explained the purpose of the visit. The facility is approved to serve for (6) Developmentally Disabled Adults, ages 18 through 59, ambulatory only. All clients residing at this facility receive case management services provided by Frank D. Lanterman Regional Center. The facility is level 3. 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. Staff are adhering to infection control requirements. The staff 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 the Infection Control Plan.

Physical Plant/Environment Safety: The facility is a single story home located in a residential neighborhood, contains a total of (3) client bedrooms, (2) bathrooms, a living room, activity/office room, kitchen, dining area, backyard and detached garage. Currently, there are six (6) 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. Bathroom has non-skid materials and contained hygiene supplies including liquid soap, paper towel and toilet paper. There is a fire place in the living room that is not secured and fully covered. Exit doors are free of any obstruction and there are no pools or large bodies of water. Backyard was inspected and has outdoor furniture but the patio umbrella is broken. Laundry area is located in the kitchen. There are two (2) fire extinguishers last serviced on 12/04/2023. Smoke alarms and carbon monoxide were tested and operable. There are no firearms or weapons stored at the facility. Water temperature reading measured within the required 105 - 120 degrees Fahrenheit. Readings were 114.8 deg F in bathroom #1 and 111 deg F in bathroom #2.

Operational Requirements: The Infection Control Plan has been developed and submitted to CCL. A fire clearance is in place. Surety Bond in the amount of $15000 is in effect and expires on 12/01/2024. Fire and Emergency Prepared ness Drill is being conducted on a monthly basis and last drill was conducted on 03/01/2024. *****REPORT CONTINUED ON LIC809-C*****