Facility Evaluation Report

On 08/22/2024 at 9:15am, Licensing Program Analyst (LPA) Zina Brown & Licensing Program Manager Janae Hammond conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with the (Annabelle Agliam, Assistant Administrator ) and the purpose of today’s visit was explained. The facility is licensed to operate for (2) ambulatory, (1) non-ambulatory, (0) bedridden (developmentally disabled ) adults ages 18 through 59. Currently, the home has (3) clients. The clients are (Harbor Regional Center) clients. None the clients have Restricted Health Care Conditions and none are utilizing postural supports or protective devices.

The facility is a one (1) story home located in a residential neighborhood. The property consists of the following: 3 client bedrooms, 1 private bathroom and 2 shared bathrooms, staff office, living room, family room, kitchen, dining room, attached garage, washer and dryer and an outdoor shaded area .

LPA conducted a records review of (3) client records, (6) staff records, (3) clients Personal & Incidental Records and reviewed the facility disaster plan. All client & Staff records were complete. The facility disaster plan was current and in compliance with Title 22 at the time of visit. LPA reviewed (3) Client Medication Administration Records and did not observed any discrepancies at the time of visit.