Facility Evaluation Report

Licensing Program Analysts (LPAs) 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 Kimberly Nephew, DSP I and Pamela Martin, DSP I and explained the purpose of the visit. At 9:45am, Administrator Melinda Pippens arrived and assisted LPAs with the visit. The facility is licensed to care for (4) ambulatory Developmentally Disabled Adults ages 18 through 59 of which (2) may be non ambulatory in bedrooms 3 & 4. Facility is approved for delayed egress on exterior gate only. Facility is a level 4I and serviced by Frank D. Lanterman Regional Center.

LPAs 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. The facility has submitted a COVID-19 Mitigation Plan and Infection Control Plan. Bathrooms have hand washing signs, soap and paper towels. Staff are adhering to infection control requirements.

Physical Plant/Environment Safety: The facility is a single story home located in a residential neighborhood, contains a total of (4) client bedrooms, (3) bathrooms, a living room, kitchen, dining area, backyard, and a detached garage. LPAs observed a ring buzzer with audio on the front door and the back door. 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. Bathrooms have non-skid materials and contained hygiene supplies includ ing liquid soap, paper towels, and toilet paper. LPAs observed holes in the walls in bedrooms #2 & #3 and the exhaust fan in bathroom #1 is broken and uncovered. Exit doors are free of any obstruction and there are no pools or large bodies of water. Backyard was inspected and there were no debris or any obstructions. Kitchen knives, sharps objects, cleaning supplies and toxic substances are locked and inaccessible to clients. There are (3) fire extinguishers without tags or proof of purchase. Administrator purchased new fire extinguishers and provided proof of purchase to LPAs. Smoke alarms and carbon monoxide were tested and operable. There are no firearms or weapons stored at the facility. Water temperature readings measured within the required 105-120 degrees Fahrenheit.

Operational Requirements: A current Plan of Operation was reviewed. The Infection Control Plan has been submitted to CCL. A fire clearance for (4) clients is in place. Surety Bond is valid with bond amount of $3000. Fire Drill and Earthquake/Disaster Drills were last conducted on 06/22/2023 and 07/18/2023 respectively. *****REPORT CONTINUED ON LIC809-C****