Facility Evaluation Report

Licensing Program Analyst (LPA) Nune Margaryan conducted an unannounced annual visit. LPA met with staff Xuexiang Wu. Administrator arrived shortly after who assisted with the visit. LPA explained the reason for the visit. LPA used the CARE infection tool to evaluate the facility. The physical plant was inspected along with medications, food supply, and clients and staff records. Facility submitted infection control plan to CDSS. The facility is licensed to serve developmentally disable clients between the ages 18 to 59. There are currently 3 clients residing at the home and receive services from San Gabriel / Pomona regional Center.

The facility is a single-story house and located at a residential neighborhood area. LPA toured the home and inspected living room, kitchen, dining room, office area, activity room, client bedrooms, 2 bathrooms, laundry room, attached garage, front yard and back yard. Backyard has a shaded seating area for clients use. The front and backyard are well maintained and there are no pools or large bodies of water. Passageways and exits are free of obstruction. Facility common areas are fully furnished for client use. Client bedrooms were checked. Each bedroom is equipped with the proper furnishings. Bedrooms also have sufficient closet space. The bathrooms were toured. Bathrooms are clean and have the required hygiene items. The hot water temperature was tested in both bathrooms and was measured within Title 22 Regulation guidelines. Extra linens, blankets, towels, and personal hygiene supplies were observed. The kitchen was inspected. There is sufficient perishable and non-perishable food. All the appliances are clean and working properly. Sharps are locked and are inaccessible to clients. Chemicals and all cleaning supplies observed locked in the kitchen and in the laundry room and are inaccessible to clients. Fire extinguishers observed fully charged. Carbon monoxide detectors in the hallway and in the client rooms are operational.