Facility Evaluation Report

Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year visit. The purpose of the visit was explained to DSP Roman Palma. Administrator Tes Sison arrived shortly after. The facility is licensed as level 4E Adult Residential Facility (ARF) that serves developmentally disabled residents ages 59 and under vendored by Eastern Los Angeles Regional Center.

Infection Control: The Infection Control Plan includes Environmental cleaning and disinfection activities. Facility has sufficient Personal Protective Equipment/supplies.

Physical Plant/Environment Safety: The facility is a single story home located in a residential neighborhood. It consists of 3 resident bedrooms, 1 staff room w/office, 3 bathrooms, office/med room, dining room, kitchen, living room, family room, outdoor patio, and attached garage. Smoke and carbon monoxide detectors were tested and are operational. The facility has one (1) fire extinguisher and a fire pull alarm. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. The facility has a 1st Aid Kit and Manual. Cleaning supplies, knives, and toxic substances are inaccessible to residents. Exit doors are free of any obstruction and there are no pools or large bodies of water.

Operational Requirements: Fire clearance is approved for three (3) ambulatory and one (1) non-ambulatory resident. Care and supervision to meet the clients needs was observed. The Surety Bond is current. Special equipment (Hoyer Lift) was recently purchased for use with R1. A technical advisory was issued pertaining to Hoyer Lift.

Staffing: A total of 5 staff members provide care and supervision to the clients.