Facility Evaluation Report

Licensing Program Analyst (LPA) Tao conducted an unannounced annual inspection. The facility is licensed to serve six (6) Non-Ambulatory clients, (age 18-59). LPA met with staff#1. San Gabriel Pomona Regional Center provides case management service to clients residing in this home. LPA discussed the purpose of today's visit. Facility annual fee is current.

During the visit, LPA applied the CARE tool, interviewed staff and clients, toured the facility, checked food supply and reviewed medications. The home is located in a residential neighborhood within the city of Covina and is a single-family house which consists of a living room, attached garage/storage, dining area, kitchen, three (3) client bedrooms and two (2) bathrooms. The required two (2) days perishable and seven (7) days non- perishable were observed. Clients’ bedrooms had the required furnishing and in compliance. Adequate linen and personal hygiene supply were observed. Smoke detectors were combined with carbon monoxide detectors are operational. Last fire drill was conducted on 10/01/23. Fire extinguisher was fully charged. Sharp items such as knives are locked in the kitchen cabinet. Hot water temperature measured at 115.5 degrees Fahrenheit which in compliance with Title 22 regulations. Pesticides/poisons were not stored in food areas, kitchen, or where kitchen equipment/utensils were stored. Medications were centrally stored, locked in a storage room, and medication records were properly logged and current.

Deficiencies were cited per California Code of Regulations, Title 22, Division 6. An exit interview was conducted with staff#1 at the facility and discussed citations with Administrator, Christopher Sorto over the phone. A copy of the report and appeal rights were provided to staff#1