Facility Evaluation Report

At approximately 9:20AM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a 1-Year Required Visit and met with Staff Member, Gustavo Carvajal. Administrator, Rodrigue Ndomo, arrived at approximately 10AM. Facility serves Clients with Disabilities and has an approved fire clearance and capacity for 3 Non-Ambulatory clients. Upon arrival, LPA was informed that there were 3 clients in care and 6 staff members on-site.

At approximately 9:25AM, LPA reviewed the Facility's Staff Roster and found that Staff Member 1 (S1) was not fingerprint cleared or associated to the facility as required. Administrator notified S1 to leave the premises during visit (deficiency cited and civil penalty issued, see LIC809D and LIC421BG, Health and Safety Code 1522(c)(1)).

At approximately 9:45AM, LPA conducted a walk-though of the facility with Staff Member. LPA observed the following: Facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Facility had emergency lighting. Facility is a 1 story building with 3 Client bedrooms, 2 bathrooms, and common spaces. Facility has an Infection Control plan on file. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Toxins and dangerous items were observed to be stored inaccessible to clients. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for clients. Mattress pads were in place or available for Client use. Hot water temperatures for all sinks in facility were within Title 22 regulations of 105 to 120 degrees Fahrenheit.

Facility's fire extinguishers were last inspected May 2024. Facility's smoke detectors and carbon monoxide detectors were tested and operational. Facility's last emergency/disaster drill was conducted September 2024.

LPA reviewed staff files, client files, client medication, and P&I monies. All files were all found to be well organized, thorough and contained the required documentation. Staff files had current First Aid and CPR certification. Medication was observed to be centrally stored and secure. P&I monies were documented, secure and not commingled. Administrator's Certificate for Rodrigue Ndomo (7017219735) was current with an expiration date of 10/02/2025.