Facility Evaluation Report

Licensing Program Analysts (LPAs) Bennette Pena and Gabriela Castro conducted an unannounced Required- 1 year visit. LPAs were met by Efnan Scott, Administrator and explained the purpose of the visit. This facility is licensed as an Adult cliential Facility for Persons with Special Healthcare Needs (ARFPSHN) and is vendored by the San Gabriel/Pomona Regional Center. The facility is approved to serve (5) developmentally disabled clients ages 18 and above, (5) clients may be bedridden. LPAs utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: Facility has one (1) person capable and responsible for communicating with emergency personnel in the facility at all times. Contact information of each clients' medical and mental health providers, including emergency agency are current.

Physical Plant/Environment Safety: T he facility is a single story home located in a cliential neighborhood which consists of (5) client bedrooms, (2) bathrooms, staff office, living room, t.v. room, dining space, kitchen, laundry room, and attached garage. The backyard has a shaded area. There are no pools or bodies of water and no items obstructing the walkway. The client bedrooms are equipped with mechanical lifts. The shared bathroom is clean and sanitized. The fire extinguishers are inspected annually and is fully charged. The facility checks and documents the hot water temperature and refrigerators temperature on a daily basis. Facility has backup generators and are checked every 2 weeks.

Operational Requirements: A fire clearance is in place. Facility has doctor's authorization for use of half bed rails. Staff are adhering to operational requirements. Health and Safety Code Statutes adhered to as well. Emergency drills are being conducted as required. Facility maintains and operates automated external defibrillator (AED) and meets the requirements. LPAs also reviewed the P&I ledger for the clients. Surety bond is valid in the amount of $2000.*****REPORT CONTINUED ON LIC809-C*****