Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the required annual inspection using the Compliance and Regulatory Enforcement (CARE) tool. LPA arrived unannounced and met with Staff, Elenita Ilao. Administrator,Mercedita Sibal, arrived shortly after. The facility is licensed for (4) ambulatory developmentally disabled adults, ages 18 to 59. There are currently four (4) ambulatory adults residing at the faciltiy and receiving services from the San Gabriel/Pomona Regional Center.

The facility has (4) client bedrooms, (1) administrator's office, (2) bathrooms, dining room, family room. kitchen, and attached garage. Each client has their own bedroom with appropriate furniture and storage space. There are extra linens and hygiene supplies. Facility has operable smoke and carbon monoxide detectors throughout the home. Knives, cleaning solutions, and disinfectants are locked. The hot water temperature was measure within the required range of 105-120 degrees F. LPA observed sufficient food supplies of 2 day perishable and a week of non-perishable items. Foods are properly stored in the refrigerator to avoid contamination. Staff are continuing to follow their infection control plan and procedures. LPA reviewed records for (4) clients and their medications. The required documents and P&I ledgers are in their files. Medications are centrally stored and locked in a cabinet inside the administrator's office. Medications were checked. LPA also reviewed 3 staff files. The administrator's certificate expires on 2/15/27. Staff files have the personnel record, health screening with TB results, CPR & First Aid certificates, and annual training. Staff do not use any manual restraints on clients.

Facility reviews the emergency disaster plan annually and conducts quarterly drills.

No deficiencies were observed today. A copy of this report was given to the Administrator.