Facility Evaluation Report

Licensing Program Analyst (LPA) Tao, conducted an unannounced annual inspection. The facility has a capacity of four (4). The facility is licensed to serve four (4) ambulatory, age 18-59 clients. Client census is two (2). LPA was allowed entry by Licensee, Jennifer Oglesby (Howard). San Gabriel Pomona Regional Center provides case management service to client residing in this home. Facility annual fees are current. LPA discussed the purpose of today's visit.

During the visit, the following domain of the new inspection tool was used: infection control domain; a tour of the facility conducted; food supply was reviewed; and medications were reviewed.

LPA toured the facility inside and outside with Licensee. The facility was a single-story home consisted of three (3) client’s bedrooms, one (1) bathroom, a kitchen, a dining room, a living room, an administration office, and a detached garage with laundry area. The home is located in a residential neighborhood within the city of Covina.

The kitchen is clean and has maintained the required two (2) days perishable and seven (7) days non- perishable. All burners and stove tops were in working condition. Clients’ bedrooms have beds, dressers, chairs and closet space available. Lamps/lights for each room were available to ensure the safety and comfort of all persons in the facility.