Facility Evaluation Report

Licensing Program Analyst (LPA) Michelle Echeverria arrived unannounced to conduct the required annual visit to the facility. LPA met with Staff, Hailyn Martinez and introduced self and stated purpose of the visit. Staff, Samuel Adubi and Licensee, David Adubi arrived shortly after to assist with the inspection.

The facility has four (4) bedrooms, two (2) bathrooms, living room, family room, kitchen, dining area, laundry room, one attached car garage used as an office, attached 2 car garage, back yard with shed. LPA completed a walk through of facility, review of records, medication and P&I audit. LPA toured the interior and exterior areas of the facility.

Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). The facility is vendorized by Inland Regional Center. The facility is maintained at a comfortable temperature of 74 degrees Fahrenheit. LPA inspected client bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, chairs and some lighting. LPA observed bedroom #2 and bedroom #4 lights not properly working and need to be replaced. Deficiency issued. LPA inspected client bathrooms; bathrooms were clean and appliances were found functional. Water temperatures tested at 99 degrees Fahrenheit. LPA observed that the water temperature in the bathroom faucet did not measure within regulation. Deficiency issued. The facility is equipped with operational smoke detectors, carbon monoxide alarms, first aid kit, emergency kits and fire extinguisher. Posters such as; the personal rights, CCL complaint poster, house rules emergency disaster plans were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inside a locked closet made inaccessible to clients. There was a designated storage space for client/staff files. Medications was observed inside locked cabinets and inaccessible to clients in care. LPA observed the following issues: bedroom #1 closet doors are out of place and needs to be repaired, exposed wiring found on the kitchen's outlet next to the house phone that needs to be repaired and the carbon monoxide alarm on top of the refrigerator without a battery was not functioning since a month ago along with 2 fire extinguishers without proof of annual servicing.. Deficiency issued. LPA observed that the exit door in the garage is obstructed with an electric chair, table and boxes. Deficiency issued.