Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Ramirez and LPA Christian Gutierrez conducted an unannounced Annual Required Visit on 03/20/2024. LPAs were met by Administrator Roberto Ronas and back up Administrator Mona Liza Dela Rosa, and explained the purpose of the visit. Facility is licensed to developmentally disabled clients 18 years old to 59 years old. There are six (6) level 4C developmentally disabled clients at this facility and are receiving services from San Gabriel Valley/Pomona Regional Center. LPA requested and obtained a copy of Personnel Report (LIC 500), and Resident Roster (LIC 9020).

LPA OBSERVATIONS: Tour began at 8:27 am and was led by Administrator Ronas. The Facility is a single-story dwelling located on a residential street. The facility consists of front yard/back yard, three (3) shared client bedrooms, two (2) shared client bathrooms, kitchen, living room, dining room, den/tv room, laundry room, staff office, and attached garage.

Front Yard: LPA Ramirez observed front yard to be free of hazards.

Kitchen: LPA Ramirez observed appliances to be clean and in working order. LPA Ramirez observed sufficient 2 days of perishables and 7-day supply on non-perishables. LPA Ramirez observed knives and sharps located kitchen cabinet, to be inaccessible to six (6) out of six (6) clients in care. LPA Ramirez observed several bottles of cleaning solutions and disinfectants located in bottom kitchen cabinet to be inaccessible to six (6) out of six (6) clients in care. Signs promoting hand washing were observed in this area. Meal plan was observed in this area for clients in care. First Aid kit was observed and inspected in this area.

Dining Room/Living room: Dining room was observed to contain one table with six (6) chairs. The living room was observed to contain plenty of lighting. LPA Ramirez observed a fully charged fire extinguisher nearby. LPA Ramirez observed nearby thermostat to read 70 degrees F.