Facility Evaluation Report

Licensing Program Analyst (LPA), Mayra Cota, conducted an unannounced annual visit today. LPA met with Alex Tran, RN House Manager, and the reason for the visit was explained.

This Adult Residential Facility for Persons with Special Health Care Needs (ARFPSHN) is licensed to serve (5) adults ages 18 through 59 and (5) may be bedridden. The facility is operating within the scope of its license. Clients in care received services through the Eastern Los Angeles Regional Center. There are currently (5) clients living in the home. The home is in a residential area of Temple City, and it consists of, living room, dining area, kitchen, staff office, (5) client bedrooms, (1) staff and (1) client bathroom, attached garage with laundry area, side patio and backyard.

During today’s visit, LPA observed the following:

The facility is clean inside and out. Walkways, passageways and exits are free of debris and obstructions. Living room and dining area are spacious and accessible for client mobility devices. Kitchen was observed clean and appliances were working properly. The facility has sufficient food/formula for clients. Extra feeding supplies and formula are kept in storage closet. Oxygen tanks are kept properly stored and storage area has oxygen posting visible on the door. Client bedrooms have the required furniture and bedding, and medical-grade beds are appropriately maintained and in good repair. Client bathroom was observed clean and sanitary. Extra towels and personal hygiene products are available for use. Water temperature was tested and measured at 114.7 degrees F. which is within compliance range. The garage is kept clean and extra emergency food and personal hygiene supplies are properly stored and readily available for use. Laundry appliances are operational and in good condition. Side patio has a shaded area and garden is well maintained. Additional seating was observed in the backyard. ***Continues on LIC 809-C***