Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Ramirez and LPA Sakinah Madyun conducted an unannounced Annual required visit on 04/25/2025. LPAs were met by Administrator Samuel Benedict Cabaron and explained the purpose of the visit. The facility is licensed serve four (4) developmentally disabled clients 18-59 years old, of which two (2) may be non-ambulatory. All clients in the facility receive services from San Gabriel/Pomona Regional Center. Video surveillance was observed in common areas and outside perimeter.

LPA OBSERVATIONS: The facility is a single-story dwelling located in a residential area with four (4) client bedrooms, two (2) bathrooms, kitchen, dining room, living room, attached garage, front yard, and backyard.

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

Kitchen: LPA Ramirez observed appliances to be in working order. LPA Ramirez observed sufficient 2 days of perishables and 7-day supply on non-perishables. LPA Ramirez observed fully charged fire extinguishers nearby.

Dining Room/Living room: Dining room was observed to contain one table with six (6) chairs. Living room was observed to contain plenty of lighting. LPA Ramirez observed a fully charged fire extinguisher nearby. LPA Ramirez observed signage promoting cough and hand washing etiquette in this area. LPA Ramirez observed nearby thermostat to read 72 degrees F.

Linen Closet/Supply Closet: Observed to contain plenty linens, towels, and hygiene products.

Client Rooms 1 - 4: LPA Ramirez observed all client bedrooms to contain the required linens, furnishings, and lighting. All client bedrooms are private