Facility Evaluation Report

Licensing Program Analyst (LPA) S Vaid conducted an unannounced annual visit at the facility using the Compliance and Regulatory Enforcement (CARE) inspection tool. LPA met with Charlotte Heim and explained the reason for the visit.

LPA conducted a tour of the facility with Charlotte Heim and observed the following:

I nfection Control: Facility scans visitors. Office space stores PPE supplies and additional cleaning supplies. LPA reviewed infection control plan.

Physical Plant/ Environment: The facility is licensed to serve six (6) developmentally disabled adults ages 18 thru 59 years, of which two (2) can be non-ambulatory clients. Facility is a single-story home in a residential neighborhood and consist of three (3) bedrooms, office/storage room, two (2) full bathrooms, a living room, kitchen, dining area, backyard, a laundry room, and detached garage. Facility observed to be clean and in good repair, interior and exterior. Bedrooms three (3) are shared bedrooms and have sufficient lighting, furniture, and bedding supplies. Bathrooms two (2) were observed in working condition and water temperature was tested as follow in bathroom #1(inside room #1) 110.7 degrees F. and bathroom #2 water temperature tested at 115.7 which is within the required 105-120 degrees F. The front porch serves as the shaded seating area. Backyard has seating space. Smoke/Carbon Monoxide detectors were tested and in working condition. No large bodies of water were observed. Fire extinguisher was observed.

Operational Requirements: Program design reviewed. Fire clearance approved by LA FD for two (2) non-ambulatory clients.