Facility Evaluation Report

Licensing Program Analyst (LPA) Nune Margaryan conducted an unannounced annual visit using the Care Tool. LPA met with staff Leonora Cirilo. House Manager Emma Banguguilan arrived shortly after who assisted with the visit. LPA explained the reason for the visit.

The physical plant was inspected along with medications, food supply, and resident and staff records. The facility is licensed to serve developmentally disable clients between the ages 18 to 59 and vendorized by San Gabriel/Pomona Regional Center. There are five (5) ambulatory and one (1) non-ambulatory client who reside in the home. At the time of visit 3 clients were at the Day Program.

LPA toured the home and inspected three (3) client bedrooms, one (1) staff room two (2) bathrooms (one related to the staff room), kitchen, dining room, living room, and detached garage. The front and backyard are well maintained and there are no pools or large bodies of water. Passageways and exits are free of obstruction. There is a shaded seating area for the clients located in the backyard. Laundry was observed in the garage. LPA observed laundry detergent locked in the cabinet and not accessible to clients. There is only one entrance being utilized at the facility. There is a fireplace located in the living room area which is covered / blocked with the office desk.

Client bedrooms were checked. Each bedroom has a smoke / carbon monoxide dedector, bed, linen, dresser, light, and sufficient closet space. Extra blankets, linens were observed in the closet located in the hallway. The client bathrooms were toured. Bathrooms have the required hygiene items, grab bars and non-skid mat. The hot water temperature was tested and was measured 143.5 degrees F. Cleaning supplies were observed unlocked in the bathroom which related to the staff room. Discontinued medications for the clients that should be destructed / returned to the pharmacy were observed unlocked in the staff room. The kitchen was inspected. There is sufficient perishable and non-perishable food. All the appliances are clean and working properly. Sharps are locked in a kitchen cabinet inaccessible to clients.