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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435202688
Report Date: 11/29/2022
Date Signed: 11/29/2022 02:15:56 PM

Document Has Been Signed on 11/29/2022 02:15 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME:MORGAN AUTISM CENTERFACILITY NUMBER:
435202688
ADMINISTRATOR:BRAD BOARDMANFACILITY TYPE:
775
ADDRESS:950 ST. ELIZABETH DRIVETELEPHONE:
(408) 241-8161
CITY:SAN JOSESTATE: CAZIP CODE:
95126
CAPACITY: 50CENSUS: 38DATE:
11/29/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:25 PM
MET WITH:Hailey BarkerTIME COMPLETED:
02:20 PM
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Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to conduct the facility's annual inspection focusing on infection control. LPA met with Program Directors, Hailey Barker and Ayako Sasaki.

During visit, LPA toured the facility to include the activity rooms, kitchen, bathrooms, and exterior. All fire exit routes were free and clear of obstruction. All clients and staff were observed wearing a face mask.

Facility has a designated entry point for symptom screening, temperature check, and sign-in for all visitors, clients, and staff. Hand sanitizer and clean face masks made available at entry and throughout the facility. LPA observed the facility's Personal Protective Equipment (PPE) supplies. Facility has a bin of PPE supplies located at every activity station. Facility staff clean and disinfect multiple times daily and as needed. Bathrooms are supplied with hygiene products, paper supplies, hand washing sign, and lidded trash bin. Facility staff have been provided training on infection control. LPA reviewed the facility's procedures to visitation and screening. The following posters observed to include required face mask and symptoms of COVID-19.

Facility has procedures to isolation when a client becomes symptomatic. LPA observed the isolation room located next to an exit. LPA recommended to create an "isolation room in use" sign and a complete PPE bin to place next to the isolation room when needed.

No deficiencies were cited per California Code of Regulations, Title 22. Advisory notes provided.

This report was reviewed with Hailey Barker and a copy of the report was provided.
SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: Christine Dolores
LICENSING EVALUATOR SIGNATURE: DATE: 11/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/29/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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