Facility Evaluation Report

A Required One (1) year visit was conducted today by Licensing Program Analyst (LPA) Gary Tan. LPA met with staff Patrick Baltazar who the Administrator Doris Duong and purpose of the visit stated. Ms. Duong designated Mr. Baltazar to sign the report. This is a North Los Angeles Regional Center vendored facility level II.

A tour of the physical plant was conducted at 9:15 AM and the following was noted:

The front main door is the only entrance being utilized at the facility. There is a sign on the front gate preceding the main door that everyone entering at the facility must be screened. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available. The facility had submitted and approved Mitigation and Infection Plan.

Signs to wear a mask and other Covid 19 prevention protocol signs were posted outside the doors. Hand washing, coughing etiquette, physical distancing and other necessary signs were posted in the bathroom and all over the facility. All trash cans were observed to be with cover.

The facility has a designated visitors' area at the backyard. The facility has sufficient stock of PPE in the garage.

Facility has four (4) private client bedrooms and has two (2) bathrooms. Additional two (2) bedrooms are designated for staff use. There is no body water in the facility.

Bedrooms were toured and observed to be clean and properly furnished. Linen storage was also checked and observed to have ample supply of clean linen and towels.

Bathrooms were observed to be clean and sanitary with necessary supplies. Hot water temperature was measured at a range of 110.2°F to 116.7°F and within the required range. (continued to LIC 809-C)