Facility Evaluation Report

***This amended report was created to correct the Administrator name on the report. On 6/4/2024, Licensing Program Analyst (LPA) Noemi Galarza made an unannounced annual inspection visit. The purpose of the visit was explained to DSP Eric Hanson. Administrator John Nguyen arrived shortly after. The facility is a Specialized level 4b Adult Residential Facility (ARF) that serves developmentally disabled residents ages 59 and under vendored by Eastern Los Angeles Regional Center. The home consists of a two-story home licensed for 6 non- ambulatory residents. It is located in a residential area consisting of five (5) client bedrooms, (1) staff rooms, 3 bathrooms, kitchen, dining room, laundry room, living room, family room, patio area, and attached garage. The following 12 (CARE) tool domains were utilized during the inspection.

Infection Control: Facility staff are no longer screening visitors. Hand hygiene and disinfectant cleaning protocols are in place. An Infection Control Plan was reviewed.

Physical Plant/Environment Safety: The interior and exterior physical plant was inspected. Exit doors are free of any obstruction and there are no pools or large bodies of water. Smoke and carbon monoxide detectors were tested and are operation. The facility has two (2) fully charged fire extinguishers. Hot water temperature readings measured between the required 105 - 120 degrees Fahrenheit. The facility is equipped with a sprinkler system. The last fire inspection was conducted on 7/6/2023 by San Marino Security Systems Inc.

Resident (R1 & R2's) room walls/baseboards, upstairs bathroom faucet and kitchen faucet, and entrance baseboard are in disrepair.

Storage areas for cleaning solutions/toxins, knives, and hazardous items were inaccessible to clients; with the exception of 1 kitchen cabinet that contained a pair of scissors that were unlocked.

Operational Requirements: The Program Design was reviewed. Fire clearance is approved for six (6) non-ambulatory residents. Care and supervision to meet the clients needs was observed. No special equipment and supplies are used by residents. Facility manages residents P & I monies. The Surety Bond was effective 2/28/2024.

Staffing: A total of 10 staff members provide care and supervision to the clients.