Facility Evaluation Report

Licensing Program Analyst (LPAs) Claudia Gutierrez and Nancy Guillen made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPAs were greeted and granted entry by Staff Andrea Leyva and the purpose of the inspection was discussed. Compliance Specialist Maggie Sumioka and Residential Supervisor (RS) Amber Wofford were contacted by phone and arrived at 9:30 a.m. and 10:00 a.m. respectively.

During the inspection, LPA Gutierrez and Therapist (TH) Diana Su conducted a tour of the inside and outside of the facility, common areas, client rooms, kitchen, garage and observed the following:

This is a two-story home with four client bedrooms, six bathrooms, three staff offices, one learning lab room, one dining room, one family room, one kitchen, one laundry room, one recreation room, one hallway storage closet, one medication room and two garages located on the first floor. The second story of the facility is located directly above the recreation room and contains two therapist offices. All client bedrooms had the required furnishings. LPA observed all client beds had linens and blankets. LPA observed all windows were screened. The backyard has a shaded sitting area, tennis court, and in-ground swimming pool. Pool was observed to fenced with a self-latching door. Upon arrival, LPA observed two direct care staff and all four clients leaving for a community outing. Bathrooms were observed to be free of debris and mildew, faucets and toilets were operational. Water temperature tested between 109.7 - 112.2 F degrees. LPA observed emergency disaster plan with means of exiting and emergency phone numbers listed and posted at the entrance of the facility. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Smoke detectors and carbon monoxide detectors tested operational. Fire extinguishers were observed to be mounted and fully charged with a service tag dated January 4, 2024. Gas stove, microwave, washer, and dryer were all inspected and tested operable. Sharps were observed locked in a kitchen drawer. All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to clients. Medication is kept in a cabinet within the medication room, both medication cabinet and medication room were observed to be locked. (Cont. LIC809-C)