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 Glorie Pascasio arrived shortly after.

The facility is licensed to serve four (4) adults ages 18-59, non-ambulatory. There are currently three (3) clients residing in the home, one is in the hospital and all clients 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, 4 client bedrooms, 2 bathroom, laundry area in the attached 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. 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 in a locked cabinet located in the garage.

Centrally stored medications were observed secured in a locked hall closet. The facility uses the Medication Administration Record (MAR) log to document medications given.