Facility Evaluation Report

A Required One (1) year visit was conducted today by Licensing Program Analyst (LPA) Jose Tan. LPA met with Administrator Carlos Hinojosa . Purpose of visit was stated. This facility is North Los Angeles Regional Center vendored facility Level II.

A tour of the physical plant was conducted at 9:22 AM and the following was noted:

The facility has a gate outside before getting into the facility. The only entrance being utilized is the main front door, there is a sign at the main door that everyone entering at the facility must wear mask. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available.

The facility had submitted and approved Mitigation and Infection Control Plan. All trash cans were observed to be with cover. The facility has a designated visitors' area at the backyard. The facility has sufficient stock of PPE in the storage room.

Facility has six (6) bedrooms and two (2) bathrooms. Two (2) bedrooms and one (1) bathroom is designated for staff use. The facility is fire cleared for four (4) ambulatory residents only. There is no body of water in the facility.

Bedrooms were toured and observed to be clean and properly furnished. Linen storage was also checked and observed to have ample supply of clean linen and towels.

Bathrooms were observed to be clean and sanitary with necessary supplies. Hot water temperature measured at 118.6°F and within the required range. (continued to LIC 809-C)