Facility Evaluation Report

Licensing Program Analyst Gabriela Castro conducted an unannounced required annual visit using the Compliance and Regulatory Enforcement (CARE) Tool. LPA was greeted by Jonathan Vanmou, LVN and explained the reason for the visit. Facility Backup Admin. Liezl Tuason arrived shortly thereafter.

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 five (5) developmentally disabled clients ages 18 and above; of which five (5) may be bedridden.

Personal Rights postings were observed in a common areas. Residents had access to personal space, privacy, and adequate storage. No firearms/weapons were present. During today’s visit, LPA observed four (4) staff members providing direct care and supervision to clients in care.

The facility is a single-story home that contains five (5) bedrooms, three (3) bathrooms, a living room, TV room, dining room, laundry room, backyard shaded patio area, and an attached garage. All five (5) bedrooms are equipped with mechanical lifts. Of the three (3) bathrooms, one (1) bathroom is equipped with a mechanical lift. All five (5) bedrooms contained the required furniture and adequate lighting. Water temperatures were measured as follows: Bathroom #1 measured at 116.7°F; Bathroom #2 measured at 117.3°F; and Restroom #3 (staff restroom) measured at 117.4°F. The mechanical lift in Bathroom #1 was tested and found to be operable during the visit. LPA also observed a shower gurney in Bathroom #1. All client bathrooms were observed to be clean, and signs promoting proper hand washing were posted. Smoke and carbon monoxide detectors were tested and found to be operational. Charged fire extinguishers were observed throughout the facility. Oxygen use signs were posted throughout the facility . All exits were clear of obstruction, and no bodies of water were observed on the premises. In the laundry area, laundry soap and supplies were stored in a manner that made them inaccessible to the four (4) clients in care. The attached garage was observed to contain a generator, which was tested during the visit. Emergency water, food, and disaster supplies were also observed stored in the garage.