Facility Evaluation Report

On 07/01/25 Licensing Program Analyst (LPA) Villegas conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Administrator Shawn Cross as the purpose of today’s visit was explained. The facility is licensed to serve 6 adults with developmentally disabled ages 18-59. Current census is 3, clients in are linked to the Harbor Regional center. Administrator provided with upcoming annual fees info. ($454 PIN:405567)

The facility is a single-story home in a residential residence that consist of: 3 bedrooms, 2- ½ bathrooms, living room, dining area, den with a staff work area, kitchen, laundry area, shaded area, indoor/outdoor activity areas, and an attached garage, that houses an emergency water and food supply. Beds and bedding supplies were in good condition, adequate lighting provided, storage for client personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. The water temperature properly measured between 105-120 F.. A supply of perishable and non-perishable food was observed, toxins and knifes were stored and inaccessible to clients, no weapons nor bodies of water on the premises, exits and walkways are free of debris/hazards.

LPA conducted a records review of 3 staff record, 3 client record, 3 Medication Administration Record, and 3 P&I ledger, LPA did not observe any discrepancies at the time of visit. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked. The last fire drill was conducted on 6/22/25, 2 fire extinguishers fully charged, carbon monoxide detectors and smoke detectors are interconnected and operational, and a landline was observed.

An exit interview was conducted, and a copy of this report was provided to Administrator Shawn Cross.