Facility Evaluation Report

On 12/6/23 at 9:30am Licensing Program Analyst (LPA) Arvin Villanueva conducted an unannounced annual required visit. LPA met with the facility administrator, Fozai Hassen, and explained the purpose of today’s visit. The facility is currently licensed to serve 4 developmentally and intellectually disabled adults. Present during this visit, there were two (2) clients in care with two (2) staff on duty.

At 9:45am, LPA inspected the facility’s physical plant including but not limited to the kitchen, dining room, client bedrooms, client bathrooms, laundry room, living area, common TV area, and outside of the facility to ensure compliance with Title 22 regulations. The facility is a one-story structure located in a residential neighborhood. There were no bodies of water on the premises. Outside of the facility was observed to be clean and clear of obstructions. Additionally, LPA observed outdoor furniture for clients’ use and covered area for outdoor activities. LPA observed two (2) windows in bedroom 4 were missing of window screens. Entrance, exits and hallways were observed to be clear of obstructions. LPA observed four (4) client bedrooms, two (2) bathrooms for client use, office room and staff room. LPA observed beds and bedding supplies were in good condition, adequate lighting was provided, and sufficient storage for the client’s personal belongings. Bed linens, comforters, and bath towels were adequately stocked during the visit. The client rooms were inspected: bedrooms 1, 3, and 4 are currently occupied and bedroom 2 is currently empty. Bathrooms were operational and adequately supplied, including with grab bars and non-skid flooring.

LPA observed the facility to be furnished at the time of the visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were locked and not accessible to clients in care. The kitchen was inspected, and sufficient 2-day perishable and 7-day non-perishable food was maintained adequately. Room temperature was maintained in the facility at 72 degrees F. Water temperature in one of the bathrooms located inside bedroom 4 was initially measured at 125.8 degrees F. Administrator was observed to adjust the water heater to lower the water temperature. Second water readings in both bathrooms after the adjustment were measured between 105- and 120-degrees F. Per interview with the administrator, it was determined that staff do not keep record of hot water temperature readings and that the water temperature is checked once in a while. Fire extinguisher was serviced on 7/19/23. Smoke detectors and carbon monoxide were tested and found to be operable during this visit. Per administrator, facility has smoke detectors/carbon monoxide monitor combination.