Facility Evaluation Report

LIcensing Program Analyst(s) (LPA) Ashley Calderon conducted an unannounced annual visit at the facility with focus on using the CARE Inspection Tool. LPA Calderon met with DSP staff Quincy Tripp and explained the reason for the visit. Administrator Cheryl Jackson arrived at 2pm, LPA explained reason for the visit.

Facility is licensed to served (22) twenty two ambulatory only, developmentally disabled adults 18 - 59 years old. The facility is a two story home located in a residential neighborhood and consist of a kitchen, a total of (11) client bedrooms of which (4) are located downstairs, and (7) are located upstairs, (5) client bathrooms (3) are upstairs and (2) are downstairs, a detached garage with a laundry, backyard and front porch with shaded sitting area. Attic is empty and inaccessible to clients in care. Facility phone number: 626-792-8814 .

LPA Calderon conducted a tour of the facility with Cheryl Jackson and observed the following:

Living room and dining room were observed clean and in good condition. Kitchen was observed and had working appliances and facility m eals are prepared outside the facility , at the sister facility, Bella Vista . Facility has extra food for clients in care and can goods/ dry foods. LPA observed random client rooms.

Client #1, Client #2, Client #3, Client #4 (C1-C4), all bedrooms had sufficient lighting and bedding supplies. LPA observed C1-C4 not having adequate furniture: missing chairs and night stands, deficiencies were cited.

Downstairs bathrooms were observed to be in working condition, water temperature was tested within the required 105-120 degrees F. Bathroom upstairs near C3 bedroom did not deliver hot water in sink deficiencies were cite, far end bathroom was clean, operable and hot water was tested and measured within Title 22 regulation. Upstairs also had a staff only bathroom that is kept locked and inaccessible to clients in care. LPA during visit observed maintenance being done on floors upstairs, LPA interviewed handy man from Lozano Iron Works and confirmed repairs on downstairs flooring and walls is scheduled. LPA asked for pictures once completed. LPA did not observe evacuation chair in stairways, deficiencies were cited.

Carbon monoxide operable, smoke detectors/ fire alarms are hard wired to the Fire Department of Pasadena. Fire Drill conducted: 9/5/23.