Facility Evaluation Report

Licensing Program Analyst (LPA) Bruce Jacobs arrived at the care home to conduct an unannounced Annual inspection on this date. The Administrator for the facility, Myrna Tacsion was informed of the purpose of the visit, arrived at the home and was able to assist with the completion of the inspection focusing on the facility's mitigation plan and infection control procedures. The facility is Regional Center vendorized home and is vendorized for a 4I level. The facility has 6 clients and 3 bedrooms. The clients were at the home and engaged in virtual day program classes and other activities.

LPAs toured the facility and reviewed the Mitigation Plan as well as discussing Personnel Policies, Abuse Reporting Procedures, In-Service Training and Medication Procedures during the Post-Licensing Inspection. Smoke alarms were tested and were operable. Fire extinguishers were serviced in December 2001. Toxins and medications were locked and inaccessible to clients in care. . Food supply determined to be adequate. Inside and outdoor exits were unlocked and accessible. Water temperature was measured at 109.5 degrees F.

LPA observed the following posted in the facility: COVID requirements, Resident Bill of rights, Resident Personal Rights, Evacuation Routes and facility license were all posted as required. LIC 500, LIC 308, and LIC 309 were requested to be submitted to Licensing within 30 days as needed.