Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the unannounced annual inspection. LPA met with Carolyn Dosty, the backup administrator and informed the reason for the visit. The facility is licensed as an Adult Residential Facility for Persons with Special Healthcare Needs (ARFPSHN) and is vendorized by the East Los Angeles Regional Center. The fire clearance is approved for four (4) bedridden clients.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools to inspect the facility.

The facility is a single-story home that consists of four (4) bedrooms fully equipped with mechanical lifts, three (3) bathrooms, a living room, dining room, kitchen, laundry room, and an attached garage. The backyard has a shaded patio. There are no pools or bodies of water on the premises. Fireplaces are secured with a fence and not in use. Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients. The water temperature are measured within the required range of 105-120 degrees. Facility is continuing to follow the infection control plan and using appropriate hand hygiene. There are sufficient food supplies of 2-day perishable and a week of non-perishable items. Special diet formulas are observed.

LPA reviewed 4 staff files. The administrator's (Laurie Hernandez) certificate expires on 7/26/26. Staff files have the required documents and the CPR & First Aid certificates are current. Staff are receiving on-the-job training as appropriate to the job assigned. LPA reviewed all four (4) Client files and their medications. Files are maintained at the facility and the required documents are included. Medications are being administered as prescribed. The facility has an Emergency Disaster Plan in place and is conducting monthly drills.

No deficiencies were observed today. An exit interview was held and a copy of this report was provided to C. Dosty.