Facility Evaluation Report

Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted a Required One (1) year annual visit and inspection. LPA met with Administrator, Co-Administrator and Direct Support Professional (DSP). LPA was granted entry by DSP and explained the purpose of the visit upon arrival.

At approximately 10:15a.m., Co-Administrator and LPA conducted physical plant tour inside and outside. Required posting observed in facility hallway. The smoke alarms are operational and located in each bedroom, hallway and command areas. Carbon monoxide detectors were present and functioning properly. Fire extinguishers were observed in the kitchen area and hallway with current service tagging dated 03/09/2025. Facility temperature measured 74 degrees Fahrenheit at the time of inspection.

The facility is licensed for an Adult Residential Facility(ARF), capacity of two (02) non ambulatory and six (06) ambulatory developmentally disabled clients. Facility is vendor through San Gabriel Pomona Regional Center as level 4 home. Facility has four (04) bedrooms and two (02) bathrooms for clients and staff. Upstairs area is a bedroom/office for administrator use only and always locked. The facility is a two-story home located in a residential community. There is no body of water in the facility. Fire and Earthquake Disaster drill was last conducted on 11/09/2025. During the visit, three (03) clients were present, and four (04) additional clients were attending Day Program site.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Kitchen: The kitchen appliances and fixtures were functional. The kitchen has a working electric stove, faucet, freezer, refrigerator, and microwave -were operational and maintained in safe condition. LPA observed at least two (02) days perishable and seven (07)