Facility Evaluation Report

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced required annual inspection. LPA met with David Akuguzibwe and Habiba Alkhusaiby, Direct Support Professionals (DSPs) and explained the purpose of the visit. The facility is licensed to care for Developmentally Disabled Adults, ages 18 through 59, (4) ambulatory only. All clients residing at this facility receive case management services provided by North LA Regional Center. At 2:00pm, Moses Wakabi/Administrator arrived and assisted LPA with the inspection. LPA 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 observed. There is a visitor screening station at the entrance of the facility. The facility has submitted a COVID-19 Mitigation Plan and Infection Control Plan. Bathrooms have soap and paper towels. Staff perform hand hygiene practices and are adhering to infection control requirements.

Physical Plant/Environment Safety: The facility is a single storey home located in a residential neighborhood, contains a total of (4) client bedrooms, two (2) full bathrooms, a living room, kitchen, dining area, backyard, and attached garage. Currently, there are four (4) clients living in the facility. Facility is a Level 4G. The interior and exterior physical plant was inspected. Client bedrooms were toured . Each bedroom has a smoke detector, bed, linen, dresser, light, and sufficient closet space. Bathrooms have non-skid materials and contained hygiene supplies including liquid soap, paper towels, and toilet paper. Exit doors are free of any obstruction and there are no pools or large bodies of water. Attached garage stores PPE supplies, an extra refrigerator and freezer, and emergency food supplies. Kitchen knives, sharps objects, cleaning supplies and toxic substances are locked in the cabinet under the sink and inaccessible to clients. There is one (1) fire extinguisher observed mounted on the post next to the dining area and purchased on 8/26/2021. Smoke alarms and carbon monoxide were tested and operable. There are no firearms or weapons stored at the facility. There are no cameras in the facility. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. Hot water supply measured 107.1 deg F in bathroom #1, and 108.3 deg F in bathroom #2.

Operational Requirements: A current Plan of Operation was reviewed. The Infection Control Plan has been added to the Plan. Surety Bond Insurance (Western Surety) is valid and expires on 02/01/2027. Liability Insurance policy (policy # 9270108-2023) in the amount of $1,000,000.00 each occurrence and $3,000,000.00 in the total annual aggregate expired on 6/29/2023. Administrator showed an email from the insurance company to prove that liability insurance is being renewed. Fire Drill was last conducted on 01/15/2023 . Outdoor space/backyard was inspected and has a shaded area and sitting area.