Facility Evaluation Report

Licensing Program Analyst (LPA) Bennette Pena conducted the required annual inspection. LPA was allowed entry by Maydia Jimenez/Direct Support Professional(DSP). LPA explained the purpose of today's visit. LPA spoke with The Administrator, Ebony Campbell on the phone. Administrator was not present at the facility and scheduled to arrive at 2pm. Gloria Fletcher, Direct Sup port Professional(DSP) assisted LPA with the inspection. The facility is licensed to serve three(3) Adults 18 Years and above. Three (3) may be non-ambulatory. Current census is (2), non ambulatory and non verbal. All clients residing at this facility receive case management services provided by South Central LA Regional Center (SCLARC). At 3:50pm, the Administrator, Eboni Campbell arrived just in time to discuss and sign the reports.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: The facility staff are using appropriate hand hygiene and wearing gloves while assisting clients. Staff are cleaning and disinfecting often for high touched surfaces. Facility has sufficient PPE supplies. Facility does not have an Infection Control Plan on file. Staff are adhering to infection control requirements.

Physical Plant & Environment Safety: This facility consists of (3) bedrooms, (2) full bathrooms, living/activity room, kitchen, dining area, and detached garage. Smoke alarms were tested and operable. Fire extinguisher appeared to be full and was last serviced on 12/08/2022. Carbon monoxide tested and operable. Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients. There are no firearms or weapons stored at the facility. Hot water supply measured 118.3* in the kitchen, 116.5* in bathroom #1, and 116.8* in bathroom #2.

Operational Requirements: The fire clearance is approved for (3) non ambulatory clients. Last Fire Drill was conducted on 10/19/2022. Fire and Earthquake drill

Staffing: There is sufficient staffing at the facility. The Administrator stated that she has a valid Administrator certificate but due for renewal this year. Administrator will email LPA the valid Administrator certificate. LPA was not able to review the Administrator's file due to inaccessibility. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility.

***Refer to LIC 809C for the continuation of this report***