Senior Care Records.

Facility Evaluation Report

Kaiser Specialized Residential Fairview, San Gabriel10/05/2023Licence 198600948

Capacity4
Census4
Date signed10/05/2023 01:05:41 PM
The inspector’s account

Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA explained the purpose of the visit to DSP staff. Administrator Mohammed Shirazi arrived shortly after. There are four (4) ambulatory developmentally disabled adults. Three (3) residents are over the age of 59, and one (1) resident is under age 59. One (1) approved Age Exception is in place. Administrator has submitted 2 additional Age Exceptions that have been approved. Age Exceptions will be mailed out to licensee.

The facility is licensed as a level 4N home vendored by Eastern Los Angeles Regional Center. Twelve (12) Adult CARE tool domains were observed and reviewed.

Infection control practices and Personal Protective Equipment (PPEs) were observed. Infection Control Plan and COVID-19 Mitigation Plan, and Monkey Pox Plan were reviewed.

The facility is a single story home located in a residential neighborhood. It consists of 4 resident bedrooms, 1 office room/laundry area, 2 bathrooms, kitchen, dining room, living room, outdoor patio, and a detached garage.

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 operational. The facility has two (2) fully charged fire extinguishers.

Water temperature readings measured between the required 105 - 120 degrees Fahrenheit.

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Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction