The facility is licensed to serve 5 ambulatory and 1 non-ambulatory clients in the age range 18 through 59, and non-ambulatory client shall be in bedroom #4. The facility is operating within the scope of its license.

The facility is located in a residential are of Paramount. The facility consists of living room, kitchen, dining area, 1 staff bedroom, 4 client bedrooms, 2 client bathrooms, attached garage, front yard, and backyard.

LPA toured the facility with Daniel Adeleke and the following was observed:

The living room was observed clean, and furniture is in good repair. Clients residing in the facility were observed to be co-mingling with (4) additional clients from another facility at the time of visit. Sufficient seating space was not available in the living room and dining room areas and (3) clients were observed standing within the minimal space. Kitchen appliances are operable and observed clean. Facility has sufficient 7-day non-perishable food; however, facility does not have sufficient 2-day perishable food available for client in care. Sharps/knives are kept locked under the kitchen sink. Cleaning supplies, chemicals and toxins were observed stored in the same kitchen cabinet in which food items like cooking oil were stored. Trash bins in the facility were observed without tight-fighting lids. All bedrooms have all required furniture, lighting, and bedding. Clean towels and extra clean linen were observed in the hallway cabinets. Roaches and droppings were observed by kitchen closet, living room and staff and client bedrooms.

continued on 809C

• Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

• Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

A fire extinguisher located in the kitchen was observed to be charged and operable. Combination/interconnected smoke and carbon monoxide detectors were observed throughout the facility and were tested and operable during the visit.

The front and backyard are clean. There is a shaded area with seating in the backyard. No bodies of water were observed at the facility. Passageways and exits are free of obstruction.

Client medication is centrally stored, however, LPAs observed medication accessible to clients in a kitchen drawer, in a plastic storage bin, and inside a kitchen closet.

Record review was conducted for (5) clients and (5) staff. HIV and TB training was not observed in facility personnel file for Staff #1. Also, Staff #4 did not have TB clearance documentation in personnel file and Staff #3’s file did not have the Direct Support Personnel training documentation for staff who administers medication to clients in care. Client #6’s file with required documentation was not at the facility for review during time of visit.

Per California Code of Regulations, Title 22, and California Health and Safety Code, deficiencies are being cited today (see LIC 809-D). Exit interview conducted with Daniel Adeleke and a copy of the report and Appeal Rights were provided during time of visit. Omobola Adeleke was informed regarding outcome of the visit via telephone call and reports and Appeal Rights will be emailed to address provided.