Facility Evaluation Report

At 12:30pm, Licensing Program Analyst (LPA) Angela Panushkina arrived at the facility to conduct an unannounced annual inspection. Upon arrival, LPA was greeted by the Administrator, who granted access to the facility. LPA observed hand sanitizer and covid-19 signage posted throughout the facility’s main hallway. LPA conducted an entrance interview, and the purpose of the visit was explained.

LPA initiated a physical plant tour. Facility is an Adult Residential Facility, vendored by San Gabriel Regional Center. Facility is licensed for 6 Non-ambulatory clients. LPA was able to tour the facility and did not observe any immediate health and safety concerns. Fully charged fire extinguisher was observed in the kitchen. LPA also observed enough supplies of staple non-perishable for minimum 1 week and perishable for 2 days at the facility. All knives and sharps observed to be locked in a kitchen cabinet. Medication is centrally stored and locked in a hallway closet by the kitchen area. Facility has four (4) bedrooms, three (3) bathrooms. Bedrooms are appropriately furnished and have appropriate lighting. Bathrooms have soap, paper towels and hand washing signs. Extra towels and linens were readily available. Sufficient PPE supplies were observed in a hallway closet. At 1:00pm, Smoke detectors and carbon monoxide were tested and observed to be operational. LPA toured the outside area of the facility. LPA observed appropriate outdoor furniture, with a covered shaded area for clients. LPA discussed the importance of maintaining the care and supervision to meet the needs of clients.

Between 1:00pm to 2:00pm, LPA reviewed records of five (5) clients and two (2) staff. Client and staff records appeared to be complete and updated.

LPA collected Certificate of Liability Insurance, and LIC500.

Exit interview conducted and copy of this report signed and delivered.