Facility Evaluation Report

Licensing Program Analyst (LPA) Daniel Konishi conducted an unannounced Required-1 year visit. Upon arrival, no one answered the door and LPA called the facility number. At 2:57pm, Staff, Greg Tillman arrived and LPA explained the purpose of the visit. Staff #3 (S3) helped assist with the visit. Shortly after, Ann Hamilton, Acting Administrator arrived and LPA explained the purpose of the visit. The facility is licensed to care for twenty-two (22) Developmentally Disabled Adults ages 18 through 59, ambulatory only.

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 clean and disinfect surfaces in the common areas on a regular basis. Staff are trained in the proper use of all required PPEs. Staff are adhering to infection control requirements.

Physical Plant/Environment Safety: The facility is a two-story home located in a residential neighborhood, has a total of eleven (11) client bedrooms, with four (4) on the ground floor and seven (7) on the upper floor. There are five (5) bathrooms, with three (3) on the upper floor and two (2) on the lower floor. The facility also has a front porch with a shaded sitting area, office/storage supplies room, living room, dining area, kitchen, detached garage close to a laundry room, and backyard. 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. Extra Linens and Towels are in the 2 nd floor closet. The facility has two (2) evacuation chairs mounted on the wall nearby the stairway and 2 nd floor exit door. Carbon monoxide operable, smoke detectors/fire alarms are hard wired to the Fire Department of Pasadena. There are no pools or large bodies of water. [Continue to LIC809-C]