Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Wong conducted the required annual inspection. LPA arrived unannounced and met with DSP Celia Bugayong who allowed the entry of the facility and Shortly after, the assistant administrator Lara Langa arrived and assisted with the visit. The purpose for the visit was explained. The facility is licensed for AGE RANGE 18 THROUGH 59. APPROVED FOR 6 AMBULATORY, OF WHICH 2 MAY BE NON-AMBULATORY. BEDROOM #2 APPROVED FOR NON-AMBULATORY.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and here are the domains that LPA inspected:

1, Infection Control: The facility staff are using appropriate hand hygiene and wearing gloves while assisting the clients. Staff are cleaning and disinfecting each shift for high touched surface area. Facility has sufficient PPE supplies and has an Infection Control Plan.

2. Physical Plant and Environmental: The facility is a single story house and located around the residential neighborhood area. The facility includes: living room, dining area, kitchen, four clients bedrooms, two bathrooms, live in staff room and an attached garage with laundry area and for storage use. LPA inspected the carbon monoxide detector which is mounted on the wall near the dining area and working probably. The smoke detectors are located in each room and common area and they are working well. LPA tested the hot water temperature in two clients bathrooms and kitchen and they were tested between 105 and 110.2 degrees F. which are within the Title 22 regulation. All the sharp knives and utensils are locked in the kitchen drawer. All the cleaning supplies and chemicals are locked in the storage room in the garage. The facility has sufficient personal hygiene products for clients to use. All clients rooms are furnished and have required beddings. All the bathrooms are clean, sanitized and operational. The exit and passage way are safe and free of obstruction.