Facility Evaluation Report

Licensing Program Analysts (LPA) Jose Villalobos made an unannounced Annual inspection focused on domains within the Compliance and Regulatory Enforcement (Care) Tools . On today’s visit LPA met with staff Kenneth Croom and the purpose of the visit was discussed. Licensee Horis Hall arrived shortly after.

LPA toured the physical plant. Facility is a one story family home with three (3) bedrooms each for two (2) clients each vendorized through Eastern Los Angeles Regional Center. . There are (2) bathrooms of which (1) is for client use. There is also a living room, a den, a kitchen, central air and heating, a dining area, staff office, a laundry room, a shaded area located in the backyard. A locked attached two (2) car garage.]

Physical Plant: Outdoor and indoor passageways are free of obstruction. Bathrooms were clean and operational with non-skid mats, water temperature in compliance. Smoke/carbon monoxide detectors were tested and operational. The last fire drill was conducted on 2/28/23. Fire extinguisher observed. Sufficient supply of extra linen, towels and personal hygiene supplies observed. Central Air and Heating with temperature comfortable. Washer/Dryer appliances observed and operational. Front and back yard is in good condition, shaded area is provided. FOOD : Food supply observed. Toxins and sharps locked and inaccessible to clients. BEDROOMS: Bedrooms #1-#3 had required furnishing. All client beds have the required linen/supplies which include, pillowcase, mattress padding, fitted sheet, blanket. MEDICATION: Medications are stored, locked and inaccessible to clients. RECORD REVIEW: Facility Administrator Certificate for Marsha Haywood is active. LPA reviewed (6) client records, (4) staff files, and (6) client medications. Emergency Disaster plan reviewed. POSTINGS : Required postings observed

Care Tool was completed and based on Title 22 Regulations, California Code of Regulations Title 22, Division 6, Chapter 8 is being cited on the attached LIC 809D.

An exit interview was conducted and a copy of today's report and appeal rights was provided and discussed.