Facility Evaluation Report

Licensing Program Analyst (LPA) Blanca Gonzalez conducted an unannounced required annual visit. LPA was greeted by staff and the purpose of the visit was explained. Administrator Tamaru Francis arrived shortly after to assist.

The facility is licensed serve six (6) ambulatory, developmentally disabled clients 18-59 years old. All clients in the facility receive services from San Gabriel/Pomona Regional Center.

The facility is a single-story home located in a residential area in Covina. The home consists of three (3) shared client bedrooms, two (2) bathrooms, kitchen/dining area, living room, attached garage, front yard, and backyard.

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

Infection Control: Facility has sufficient PPE supplies and the required Infection Control Plan.

Operational Requirements: Staff have proper training to meet the needs of the clients in care. Facility has a shaded outdoor seating area.

Client Records-Incident Reports: LPA reviewed six (6) client files. All files contained the following documents: Admission Agreements, Identification & Emergency Information, current Physician's Report with ambulatory status and TB clearance, Pre-admission appraisal/Appraisal Needs & Services Plan, and IPP.