Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Ramirez and LPA Blanca Gonzalez conducted an unannounced Annual Required Visit on 04/08/2025. LPAs was met by Administrator Leilani Libang and explained the purpose of the visit. This facility is licensed as an Adult Residential Facility for Persons with Special Healthcare Needs (ARFPSHN) and is serviced by San Gabriel/Pomona Regional Center. The facility is licensed to serve four (4) developmentally disabled clients ages 18 and above; of which five (5) may be bedridden. During today’s visit, LPAs observed five (5) staff members providing direct care and supervision to clients in care. LPA Ramirez requested and obtained copies of personnel report, and client roster.

LPA OBSERVATIONS: The facility is a single-story home that contains five (5) bedrooms fully equipped with mechanical lifts, two (2) bathrooms of which one (1) is equipped with a mechanical lift, living room, TV room, kitchen, dining room, laundry room, backyard shaded patio area, and attached garage. Fully charged fire extinguishers were observed throughout the facility.

Front Yard: Was clean and well maintained. No hazards were observed. Passageways are free of any obstructions.

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 three (3) out of three (3) clients in care. Signs promoting hand washing were observed in this area.

Dining Room/Living room: Dining room was observed to be clean and contained one table with plenty of seating. Living room was observed plenty of seating and lighting.