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. LPA Tea was greeted and granted entry into the facility by Administrator (AD) Maria Jimenez. The facility is licensed for 6 ambulatory clients. Currently there are 6 clients living here during today's visit.

At 8:25 AM, LPA Tea reviewed six client files and two staff files. Client files and staff files contained all required documentation except one minor issue, there are no client admission agreements that meets Title 22. Client records contain Orange County Regional Center admission agreements. LPA advised AD to draft admission agreements based on Title 22. The administrator certificate expires on November 22, 2024.

LPA Tea along with the administrator toured the facility at 9:45 AM. LPA toured the physical plant, checked food service, and the first aid kit. The facility is a two-story home with four client bedrooms, two staff rooms, and three bathrooms. The facility has a kitchen, dining room, and living room with an attached garage. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms are 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 between 106.8 F degrees and 110.8 F degrees. 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 bandages, tweezers, thermometer, and scissors. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPA observed sharps locked in a kitchen drawer. LPA also observed toxin substances to be secured and locked and inaccessible to clients in a storage closet in the garage.