Facility Evaluation Report

Licensing Program Analyst (LPA) Jose Villalobos made an unannounced Annual inspection focused on Infection Control. On today’s visit LPA met with Administrator Mylene Bumanlag . The purpose of the visit was discussed.

As a part of the inspection, LPA used the inspection tool, reviewed (4) client records, (3) staff files, and (4) client medications. Currently the facility has (4) clients of which (4) are ambulatory. The facility is vendorized through Eastern Los Angeles Regional Center. Facility is a one story family home with Four (4) bedrooms. Bedroom #1-#4 are for one (1) client each. There are (2) bathrooms for client use. There is also a living room, a kitchen, central air and heating, a dining area, a shaded area in the frontyard. An attached car garage inaccessible to clients. Front and back yard is in good condition at time of visit. Backyard has a shed for storage and separate building for live in staff. Washer/Dryer appliances observed. Toxins and sharps locked and inaccessible to clients. All bedrooms equipped with required furniture for clients. Bathroom #1 is private for bedroom #1 and has a working toilet, wash basin, and shower. Bathroom #2 has a working toilet, wash basin, and shower Beds have the required linen/supplies which include, pillowcase, mattress padding, fitted sheet, blanket and bedspreads. Supply of hygiene supplies were observed. Fire alarms are interconnected and operational. Required postings observed. Water temperature within required tittle 22 regulations. Last Fire drill on 5/9/22.

Infection control domain completed and there were no deficiencies. An exit interview was conducted and a copy of this report was provided to Administrator Mylene Bumanlag