Facility Evaluation Report

On 10/03/2024 at 11:30 AM, Licensing Program Analyst (LPA) Jose Calderon conducted an unannounced annual inspection visit at the Ambitions Doble Avenue Facility. LPA Calderon was allowed entry into the facility by Administrator Mickca Grinage. Administrator Mickca Grinage asked infection control questions and took LPA Calderon temperature prior to entering the facility. The facility is licensed to operate for three (3) developmentally disabled adults ages 18 through 59 years. The clients are Harbor Regional Center consumers. Currently, there are three (3) residents residing in the facility, between the age of 18 and above.

LPA Calderon explained to Administrator Mickca Grinage, the purpose of the one-year Annual Inspection visit, and escorted LPA Calderon on a tour of the entire inside and outside facility grounds. As part of the inspection, LPA Calderon reviewed: Three (3) client service records, three (3) client medication records (MAR), three (3) staff records, and inspected the inside facility and outside grounds. LPA Calderon interviewed three (3) clients and three (3) staff members for visit. The facilities’ last fire drill was conducted on 08/15/2024 . The one-story residential home consists of three (3) client bedrooms, two (2) client bathrooms, living room, dining room, kitchen, staff room, office area, attached garage with washer and dryer/ storage area, backyard with table and chairs. No weapons are stored or found on the premise grounds. Kitchen was inspected and observed to be clean and operational. A two-day supply perishable and seven-day supply of non-perishable foods are present in the facility. Emergency Water Storage is in the garage area.