Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the unannounced annual inspection on 10/15/24. LPA met with Administrator, Brittany Jones, and explained the purpose of the visit. The facility is licensed for (4) ambulatory adults, ages 18 - 59 and is vendorized by the San Gabriel/Pomona Regional Center.

LPA toured the facility and conducted the inspection using the Compliance and Regulatory Enforcement (CARE) tool. The single story facility consists of 4 bedrooms, 2 bathrooms, living room, dining area, kitchen, family room/office space, laundry room, and the attached garage. There is a staff office in the garage and extra refrigerators. The facility does not have any swimming pool or bodies of water on the premises. The client bedrooms have the required furniture and bedding. Extra hygiene supplies and linens are observed. Knives, cleaning solutions, and disinfectants are locked. There are no items obstructing the hallways or outdoor walkways. The facility are continuing to follow their infection control plan and wearing when necessary while assisting clients. Staff are cleaning and disinfecting the facility daily. Sufficient food supplies and emergency foods are maintained at the home. Facility has an operable carbon monoxide detector in the hallway and smoke detectors in each bedroom. The facility is operating within the approved fire clearance. There are 4 ambulatory clients residing at the home. Staff are providing the care and supervision as necessary to meet the clients' needs. LPA reviewed 3 personnel files and all have the required documents. Staff have current CPR and First Aid certificates. Administrator's certificate expires on 8/1/26 and the HIV & TB training was completed on 12/4/23. LPA reviewed all 4 client files and included are the following documents: Admission Agreement, Physician's Report including TB results, Weight Record, Consent For Medical Treatment, Individual Program Plan/IPP, Client Rights, and Inventory form. Medications are centrally stored and locked and there were no discrepancies found. The facility has the updated Emergency Disaster Plan and is conducting disaster drills at least quarterly.

No deficiencies issued today. Exit interview held and a copy of this report was given to the administrator.