Facility Evaluation Report

Licensing Program Analyst (LPA) Cassie Yang arrived to the facility to conduct a pre-licensing inspection for change of ownership. LPA spoke with Licensee, Robert Hernandez, who explained the inspection will be conducted with House Manager, Ces Dongallo. Prior to entering the facility, LPA worn a surgical mask and was screened at entrance by House Manager. Today's census is five.

LPA and House Manager toured the interior and exterior of the facility to ensure the health and safety of clients in care. Areas toured included but not limited to: common areas, kitchen, laundry room, clients rooms, shower room and the backyard. In the areas toured, no immediate health, safety or personal rights violation was observed.

LPA observed 5 out of 5 clients and 1 House Manager, 1 licensed vocational nurse, 3 direct support professionals, and 1 respiratory therapist to be present in the facility. LPA observed the facility to have 2+ days of perishables and 7+ days of non-perishable foods in stock. LPA observed medication, toxicants, and sharps to be locked and secured. LPA observed the facility to have Ombudsman, CCLD If You See Something, and Covid-19 posters posted throughout the facility. LPA observed the fire extinguisher to be last serviced on 8/22/2022. LPA observed the refrigerator to be temperature checked early in the day at 40* degrees. LPA observed the bathroom to have hand washing signs posted, hand soap, and trash can with lid.

As a result of today's visit, no deficiencies were observed.

Comp III has been waived by Licensee as Licensee and Administrator has worked in other facilities licensed by CCLD.

Exit interview conducted with House Manager and a copy of the report will be emailed to Licensee.