Facility Evaluation Report, 09/30/2023 — Hayland Guest Home, Valinda CA

Licensing Program Analyst (LPA) Tena Herrera conducted the required annual inspection. LPA arrived unannounced and met with Justin Paul De Vera (back up Staff) and explained the purpose of today’s visit. The facility is licensed to serve 6 Ambulatory (only) Mentally Disabled adults ages 18 to 59 years old.

The facility is a single-story home located in a residential area. A tour of the facility includes: Living room, dining room, kitchen, 3 client bedrooms, 2 staff bedrooms, 2 bathrooms, front yard/back yard, covered patio and an attached garage/laundry.

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 gloves while assisting clients’ medications. Staff are still cleaning and disinfecting throughout the day. Facility has sufficient PPE supplies. There is not an Infection Control Plan on file, details will be documented on 809D.

Physical Plant & Environment Safety: Bathrooms are clean and operational. Clients’ bedrooms were checked and closet/drawer space to accommodate each client comfortably was available. The backyard is free of debris/hazards and the outdoor and passageways are free of obstruction. No bodies of water were observed at the facility. There are no security bars or weapons on the premises. Hygiene products are readily available and stored in a hall closet. The hot water temperature was tested and measured within the required range of 105-120 degrees. All storage areas for cleaning solutions, toxins, knives, and hazardous items are stored in a secured/locked area and inaccessible to clients. The last Fire/Emergency Drill was conducted on 7/1/2023. Smoke detectors and carbon monoxide detectors are operable and in compliance. The fire extinguisher was observed and is fully charged.

Operational Requirements: The facility has an approved fire clearance and outdoor activity area that is shaded and furnished for outdoor use. (Continued on 809C)