Facility Evaluation Report

Licensing Program Analyst (LPA) Tao conducted an unannounced annual inspection. The facility is licensed as Adult Residential Facility to serve for ages 18 to 59 years old, four (4) ambulatory clients, of which one (1) maybe non-ambulatory. Client census is zero (0). LPA met Gemma Rodriguez, Administrator, who assisted with the visit and discussed with Administrator about the purpose of today's visit.

During the visit, LPA conducted staff interviews, used CARE inspection tool, toured the facility, reviewed food supply, and reviewed staff records.

LPA toured the facility inside and outside. Facility does not have client. Administrator explained regional center is working on vendorizing clients to the facility. The home is located in a residential neighborhood within the city of Covina and is a one story building which consists of four (4) client bedrooms, two (2) bathrooms, kitchen, dining area near the kitchen, living room with a TV, laundry room, and backyard with a patio. The kitchen is clean and has maintained the required two (2) days perishable and seven (7) days non- perishable. Clients’ bedrooms have beds, dressers, chairs and closet space available. Adequate linen and personal hygiene supply are observed. Bathrooms are clean and operational.

Smoke detectors and carbon monoxide detectors were operable. Hot water temperature measured at 119.5 degrees Fahrenheit. Client beds were in good condition and had appropriate linens. Lamps/lights for each room were available to ensure the safety and comfort of all persons in the facility. Medications were centrally stored, locked in a cabinet located in the kitchen. Medications were properly logged and current. Hazardous items were locked and inaccessible to clients.

No deficiencies cited per California Code of Regulations, Title 22, Division 6. An exit interview was conducted. This report is discussed and provided to facility Administrator.