Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Wong conducted an annual required visit. LPA met with DSP Maryann Mercado and explained the reason for the visit. LPA used the infection control tool to evaluate the facility. LPA observed the facility plant, COVID-19 procedures, reviewed residents' medications, observed food supply.

The facility is a single story house and located in a residential neighborhood area. The facility include kitchen, dining area, living room, 4 clients bedrooms, 2 clients bathrooms and attached garage. All 4 client bedrooms were toured. Each bedroom has one bed, one drawer, night stand, required furniture and bed linen, sufficient lighting and closet space. All 2 bathrooms were toured and they are clean, sanitary and in a good working condition. The hot water temperature was tested between 111.3 and 111.5 degrees F which is within the Tittle 22 regulation. The refrigerator in the kitchen and garage has sufficient 2 days perishable food. The kitchen cabinet also has sufficient 7 days non-perishable food supply. All the appliances are clean and working properly. The common areas such as living room and dining area are clean and have the required furniture. The front and back yard are maintained well and the back yard has a shaded area and sitting area for clients to utilize. LPA also inspected the smoke detectors and carbon monoxide detectors are all working probably. The sharp knives and utensils are locked in a kitchen cabinet and inaccessible to the clients. The cleaning supplies are locked in the cabinet in the garage and inaccessible to clients.

LPA also reviewed the clients emergency contact information and they are all updated. LPA also reviewed four clients medication and they are all seemed updated and accurate

Facility is currently following COVID 19 recommendations regarding COVID 19 signs throughout the facility, facility is disinfected everyday, bathrooms have sufficient soap, paper towels, and signs, and PPE supplies are sufficient for more than 30 days.

No deficiencies were observed during the visit. Exit Interview conducted and a copy of the report was provided to DSP Maryann Mercado