Facility Evaluation Report

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA was screened and met by Sarah Torres/ Direct Support Professional I & II (DSP I & II) and explained the purpose of the visit. LPA spoke to the Administrator/Licensee Yusimi Travieso on the phone and explained the reason for the visit. At 3:15pm, Licensees Pedro and Yusimi Travieso arrived and assisted LPA with the inspection. The facility is licensed to care for (4) Developmentally Disab led Adults, ages 18 through 59, ambulatory only. All clients residing at this facility receive case management services provided by South Central Los Angeles Regional Center. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. There is a visitor screening station at the entrance of the facility. The facility has submitted a COVID-19 Mitigation Plan and Infection Control Plan. Facility does not have COVID-19 signage posted in the facility. Bathrooms have soap and paper towels. Staff are adhering to infection control requirements.

Operational Requirements: A c urrent Plan of Operation was reviewed. The Infection Control Plan has been added to the Plan. A fire clear ance for (4) clients is in place. Surety Bond Insurance (Western Surety Company) is in effect. Fire Drill was conducted on 03/22/2023.

Physical Plant/Environment Safety: The facility is a single storey home located in a residential neighborhood, contains a total of (3) client bedrooms and (2) full bathrooms, a living room/activity area, kitchen, dining area, backyard, and detached garage. Currently, there are four (4) clients living in the facility. Facility is Level 4I. The inte rior and exterior physical plant was inspected. Client bedrooms were toured. Each bedroom has a smoke detector, bed, linen, dresser, light, chair and sufficient closet space. Bathroom has non-skid materials and contained hygiene supplies including liquid soap, paper towels, and toilet paper. Exit doors are free of any obstruction and there are no pools or large bodies of water. Backyard was inspected and has a shaded area and sitting area. Detached garage was inspected and LPA observed that one of the garage doors is broken. S1 stated that a repairman has been contacted and is scheduled to fix it on Mon., 5/22/2023. Kitchen knives, sharps objects, cleaning supplies and toxic substances are locked in a cabinet and inaccessible to clients. There is a fire extinguisher observed to be fully charged and was last serviced on June 24, 2022. Smoke alarms and carbon monoxide were tested and operable. There are no firearms or weapons stored at the facility. There are no cameras in the facility. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. Hot water supply measured 109.6 deg F in the kitchen, 116.4 deg F in bathroom #1 and 118.2 deg F in bathroom #2.