Facility Evaluation Report

On 11/09/2023 at 8:02 am Licensing Program Analyst (LPA) David España conducted an unannounced Required-1-year annual visit. Upon arrival at the facility, LPA España conducted a risk assessment at the front door. Based on the assessment, the facility is clear of Covid-19 infection (No COVID-19 cases). LPA verified that the facility has an approved mitigation plan report. LPA was granted access and allowed to enter the facility to conduct the inspection.

LPA met with caregiver Katherine Tavai and later joined via telephone by Licensee Yaounde Harris and explained the purpose of today’s visit. The facility is licensed to operate for four (4) ambulatory developmentally disabled adults between the ages of 18 through 59. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) client rooms, three (3) bathrooms, living area, a dining area and kitchen. There is an outside patio area in the backyard. The garage is detached and used for storage only, including PPE, but used mostly for the owner of the premises. The laundry area is located next to the kitchen.

LPA and staff toured the physical plant. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting provided, storage for client personal belongings were observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms fixtures were operational. The water temperature did meet Title 22 standards in the bathrooms and kitchen sink. A comfortable temperature was maintained in the facility. LPA observed the facility to be appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to clients. The kitchen was inspected and there is sufficient perishable and non-perishable food available and maintained properly. There are two (2) fire extinguisher fully charge located near the dining room and in the main hallway leading to the clients’ rooms. Smoke detectors and carbon monoxide were operable and in working condition. Continued on LIC-809D