Facility Evaluation Report

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced required-1 year inspe ction. LPA met with Rosa Quintero, Direct Support Professional (DSP) and discussed the purpose of the visit. At 11am, Ginalyn Agojo, Lead Staff arrived to assist LPA. At 11:30am, Florentino Vitangcol , A dministrator arrived and assisted LPA. The facility cares for (6) developmentally disabled adults, age range 18 through 59, of which (5) may be non ambulatory. The facility is vendorized by San Gabriel Pomona Regional Center. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were maintained. Staff are adhering to infection control requirements. The facility has an Infection Control Plan and reviews the infection control procedures in the facility annually.

Physical Plant & Environment Safety: This facility is a single story home consists of (4) client bedrooms, (1) office, (3) bathrooms, den, living room, kitchen, dining room, attached garage and backyard. There are (6) clients residing in the home. Client bedrooms were toured, each bedroom has a smoke detector, bed, linen, dresser, light, chair and sufficient closet space. Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients. Water temperature readings are within the required 105 - 120 degrees Fahrenheit. Outdoor and indoor passageways were kept free of any obstruction and there are no pools or large bodies of water. Backyard was inspected and has a shaded area and sitting area.

Operational Requirements: Fire and earthquake drills are conducted monthly, last drill was conducted on 12/22/2025. L PA observed a fire extinguisher which was serviced on 10/07/2025. Surety bond insurance is valid. The facility provides a shaded and furnished outdoor activity area.

Staffing: A total of (6) staff members including the Administrator provide care and supervision to the clients. Staff employed are over the age of 18 and have criminal background clearance, fingerprint cleared, have training and associated to the facility. Administrator certificate is valid and expires on 10/22/2026.