Facility Evaluation Report

Licensing Program Analyst (LPA) Tao conducted an unannounced annual inspection visit. Upon arrival, LPA met with staff#1, who assisted with the visit. The facility serves four (4) developmental disabled, ambulatory clients, age 18 through 59 years old. All current clients were placed by Eastern LA Regional Center. LPA discussed with administrator over the phone and staff at the facility regarding the purpose of today's visit and the inspection.

During the visit, the new inspection CARE tool was used; a tour of the facility was conducted; food supply was reviewed; staff/clients files were reviewed; staff/clients interviews were conducted; and medications were reviewed. The facility is a single family home consists of four (4) clients bedrooms, two (2) bathrooms, dining room with activity area, kitchen, living room, laundry room, and patio with a covered patio area. Facility maintains the required two (2) days perishable and seven (7) days non- perishable. Clients’ bedrooms have the required furniture and in compliance. Lamps/lights for each room are available. Adequate linen and personal hygiene supply are observed. Hot water temperature was measured at 114.3 degrees Fahrenheit which was within Title 22 Regulation guidelines. Smoke detectors and carbon monoxide detectors are operable. Medications are centrally stored and locked. Medications are properly logged and current. Hazardous items are locked and inaccessible to clients. Fire extinguisher is fully charged. Pesticides/poisons are not stored in food areas, kitchen, or where kitchen equipment/utensils are stored. The front yard is well maintained. No pools or large bodies of water at the facility. Passageways are free of obstruction.

No deficiencies were observed to be in violation of California code of Regulations, Title 22, Division 6. An exit interview was conducted. This report was discussed with Staff#1 and report LIC 809s are provided .