Facility Evaluation Report

Licensing Program Analyst (LPA) Blanca Gonzalez conducted an unannounced required annual visit. LPA met with staff and explained the reason for the visit. Administrator Sandra Empson was contacted by telephone but was not able to attend.

The facility is licensed to serve four (4) Developmentally Disabled adults ages 18-59, ambulatory only. There are currently three (3) clients residing in the home, all receive services from San Gabriel/Pomona Regional Center. The facility is a single-story home located in a residential neighborhood of Covina. The home consists of kitchen, dining area, living room, den, 2 client bedrooms, 1 client bathroom, two (2) staff rooms, 1 staff bathroom, laundry room, detached garage, front and back yards.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

The front and backyard are well maintained. The facility has a hot tub in the backyard, with a secured cover. Passageways and exits are free of obstruction. There is a shaded seating area for the clients located in the backyard.

Living room and dining area were observed clean and free of obstruction with sufficient seating. Kitchen was observed clean and free of pests. LPA observed sufficient supply of nonperishable food for one week and perishable foods for a minimum of two days. Soaps, detergents, and cleaning supplies were observed to be stored under the kitchen sink, next to cooking oil. Staff promptly removed the cooking oil. Deficiency cited.