Facility Evaluation Report

On 07/29/21, at 3:22 pm, Licensing Program Analyst (LPA) Susan Campos conducted an unannounced annual required visit with a primary focus on Infection Control measures using the new CARE Inspection Tool. LPA met with Administrator Ronnell Agliam , and explained the purpose of today’s visit. This facility is a level 4I home, licensed to serve (3) Developmentally Disabled Adults age 18 – 59 with restricted health care conditions, (1) ambulatory and (2) non-ambulatory. All client are over the age of 59 years old. An age exception letter is in last admitted client’s file. Vendorized with the Harbor Regional Center

The facility is a single-story structure located in a residential neighborhood. The residential home has the following areas: 4 bedrooms, 2 bathrooms, living room, kitchen, dining room, office area with an detached garage. There is a manual threshold ramp outside the front door for wheelchair access, a gated fence surrounding the property and a commercial bus for transporting the clients to outings.

LPA and Mr. Agliam toured the physical plant. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting provided, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. The hot water temperature measured -----degrees Fahrenheit. A comfortable temperature of 75 degrees Fahrenheit was maintained in the facility.

LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available and maintained properly. Fire extinguishers were charged, smoke detectors and carbon monoxide were operable. A review of Medication Administration Records (MAR) was maintained in order and accurate.