Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced Annual Required Visit on 08/18/2023 at 9:06 am. LPA was met by Staff #1 (S1) and explained the purpose of the visit. This facility is licensed as an Adult Residential Facility for Persons with Special Healthcare Needs (ARFPSHN) and is vendored by East Los Angeles Regional Center. The facility serves three (3) developmentally disabled clients ages 18 and above; of which four (4) may be bedridden. A total of eighteen (18) staff members provide care and supervision to the clients. LPA Ramirez requested and obtained copies of Personnel Report (LIC 500), and Client Roster (LIC 9020).

LPA OBSERVATIONS: Tour began at 9:17 am and was led by S1. The facility is a single-story home that contains four (4) bedrooms fully equipped with mechanical lifts, three (3) bathrooms of which two (2) are equipped with a mechanical lift, a living room, family room, kitchen, dining room, laundry room, backyard shaded patio area, and attached garage. LPA Ramirez observed one (1) Registered Nurse (RN), one (1) Licensed Vocational Nurse (LVN), and two (2) Direct Support Personnel (DSP) during visit. Fully charged fire extinguishers were observed throughout the facility.

Front Yard: Was clean and well maintained. No hazards were observed. Passageways are free of any obstructions.