Facility Evaluation Report

Licensing Program Analyst (LPA) Wong conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA met with the administrator Eileen Singh and explained the reason of the visit. The facility is approved for AGE RANGE 18 THROUGH 59. APPROVED FOR FOUR (4) AMBULATORY. Currently the facility has no client in the facility.

The following twelve (12) tool domains were observed and reviewed: Infection Control, Physical Plant/Environmental Safety, Operational Requirements, Staffing, Personal Records-Training, Client Rights/Information, Client Records/Incident Reports, Food Service, Health Related Services, Incidental Medical Services, Disaster Preparedness and Emergency Intervention.

1. Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. The facility has an Infection Control Plan and COVID-19 mitigation plan in place.

2. Physical Plant and Environmental: The facility is a single story house and located in a residential neighborhood area. The facility includes: living room, dining area, kitchen, four clients bedroom, two clients bathrooms and an attached garage. Each client bedroom has one bed, one chair, one night stand, one drawer and required furniture and beddings and sufficient lighting and closet space. The two clients bathrooms are clean, sanitary and in a good working condition. The hot water temperature in two bathrooms were tested 105 degrees F which is within the Title 22 regulation. All the appliances in the kitchen and living room are working properly. The knives and all the sharp utensils are stored and locked in the lock box in the kitchen drawer. All the cleaning supplies and chemicals are stored and locked in the cabinet in the garage. The hallway light is always on during night time while client need to access the non-private bathroom. LPA inspected the carbon monoxide detectors is working properly. The facility also has a pool in the backyard and its locked with a five feet high fence. The passageway, walkway and the patio are free of obstruction. The facility also has a telephone service on the premises. The facility also has additional personal hygiene products for client and its stored in the hallway cabinet. The extra linen and towels also stored in the hallway cabinet.