Facility Evaluation Report

Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced visit for an Annual Inspection. Upon arrival, LPA met with Kimberly (Program Director), the purpose for the visit was explained. Facility is licensed to served 75 adults, of which 15 may be non-ambulatory, ages 18 and over.

This is a single- story facility located in Pasadena, Ca. A tour of the facility includes: lobby/locker/waiting room area, a conference room, 7 offices (some of which are used as storage), an isolation/quiet room, computer room, media room, kitchen, gym, salon (styling room), art room, staff break room, library, 4 restrooms and 2 changing rooms.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: Facility maintains the required Infection Control Plan.

Physical Plant & Environment Safety: Smoke detectors and carbon monoxide detectors are operable and in compliance, there is an emergency sprinkler system throughout the facility. The fire extinguishers were observed and are fully charged. No bodies of water were observed at the facility. The hot water temperature was tested throughout the facility restrooms and measured within the required range of 105-120 degrees. All storage areas for cleaning solutions, toxins, poisons and hazardous items are stored in a secured/locked storage closet and inaccessible to clients. There are 2 water fountains that are readily available for the clients. The facility appears to be clean safe and sanitary.

Operational Requirements: The facility has the appropriate fire clearance.