Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced Annual Required Visit on 04/28/2026. LPA Ramirez was met by Direct Support Staff Irene Sandoval and explained the purpose of the visit. The facility is licensed serve four (4) developmentally disabled clients of which four (4) may be non-ambulatory. The facility is approved for delayed egress and secured perimeters. All clients in the facility receive services from San Gabriel/Pomona Regional Center.

LPA OBSERVATIONS: The facility is a single-story dwelling located in a residential area with four (4) client bedrooms, two (2) bathrooms, kitchen, dining room, living room, laundry room, attached garage, front yard, and backyard.

Front Yard: LPA Ramirez observed front yard to be free of hazards. Front yard was well maintained. Upon arrival at the facility, LPA pushed the front gate door to alert staff of LPA's arrival. After several minutes of waiting, staff did not arrive. LPA pulled open front gate, and the gate was unlocked and LPA made way to front door. This facility is approved for secured perimeters. During facility tour, LPA asked staff (S1) to test the front gate doorbell gate. S1 tested front gate doorbell, and LPA could hear a buzzer from the inside of the facility. Staff interviews revealed the front gate doorbell normally works and staff is unsure why it is not working during LPA's visit. LPA will issue one (1) deficiency based on this observation.

Kitchen: LPA Ramirez observed appliances to be in working order. LPA Ramirez observed sufficient 2 days of perishables and 7-day supply on non-perishables. LPA Ramirez observed a fully charged fire extinguisher nearby.