Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Wong conducted the required annual inspection. LPA arrived unannounced and met with the administrator Sandra Empson who allowed the entry of the facility and assisted with the visit. The purpose for the visit was explained. The facility is LICENSED TO SERVE FOUR DEVELOPMENTALLY DISABLED CLIENTS AGES 18-59. AMBULATORY ONLY. The facility is vendored as a Level 3 Home with San Gabriel and Pomona Regional Center.

LPA Wong utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and here are the domains that LPA inspected:

1. Infection Control: The facility staff are using appropriate hand hygiene and wearing gloves while assisting clients. Staff are cleaning and disinfecting at least once a day and more often for high touched surfaces area. Facility has sufficient PPE supplies and has an Infection Control Plan.

2. Physical Plant and Environmental: The facility is a single story house and located in a residential neighborhood area. The facility includes: dining area, kitchen, living room, three client's bedrooms, administrator bedroom and bathroom, den, laundry room and detached garage. For client's bedrooms: Bedroom#1 and #3 has one bed, one chair, one drawer, required furniture and beddings and sufficient closet space and lighting, Bedroom#2 has two beds, two drawers and required furniture and beddings and sufficient lighting and closet space. The client's bathroom is clean, sanitary and in a good working condition. LPA checked the hot water temperature in client's bathroom and tested at 118.9 and it's within Title 22 regulation. The sharp knives and utensils are stored and locked in the cabinet in the laundry room. All the cleaning supplies and chemicals are stored and locked in the cabinet in the laundry room. LPA inspected the carbon monoxide detectors and smoke detectors and they are all working well. All the linen, bedsheets, and personal hygiene products are stored in the hallway closet. The hallway light is always on during night time for client to access the non-private bathrooms. The facility has a telephone service in the premises. The passageway, walkway and patio are free of obstruction. The facility has a hot tub in the backyard but it's covered up by the cover and it's not always using it.