Facility Evaluation Report

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. At around 2:20 PM, LPA Tea was greeted and granted entry into the facility by Administrator (AD) David Chase and explained the reason for the visit. Facility is licensed for six clients, two may be ambulatory and four may be non-ambulatory. Currently there are no clients in care during today's visit. AD Chase indicated that there are no clients under care due to Orange County Regional Center not vendoring the facility. The administrator hopes to move his clients from another facility, Aloe Special Care Home #306001386 to Chase Special Care Home.

LPA Tea along with the Administrator toured the facility at 2:33 PM. LPA toured the physical plant, checked food service, and the first aid kit. The home consists of 3 client bedrooms, which all are shared, 1 staff bedroom, 2 full bathrooms, living room, dining room, and kitchen. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms to be operational. Client bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each client comfortably. Client bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured at 124.5 degrees F and LPA advised the administrator that water temperature needs to be in the required temperature range when clients are present. Client bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had all the required elements including tweezers, thermometer, and scissors. Kitchen was inspected. Non-perishable food supply was checked and adequately stocked at time of visit. LPA observed sharps locked in a kitchen cabinet. LPA also observed toxin substances inaccessible to clients in care, locked and secured in a kitchen cabinet and garage. Fire extinguishers are fully charged. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there is ample seating with shade and the exit gate is self latching and operational. The backyard has a pool that is gated. LPA observed emergency supplies in the garage.

Continuation of the annual report on LIC809-C