Facility Evaluation Report

Licensing Program Analyst (LPA) Blanca Gonzalez conducted an unannounced required annual inspection. LPA was greeted by staff, and the purpose of visit was explained. Administrator Yenny Indrawati was notified and arrived shortly after.

This facility is licensed to serve residents ages 60 and over, three (3) non-ambulatory and three (3) ambulatory. Bedroom#1 may retain two (2) non-ambulatory residents and bedroom#5 may retain one (1) non-ambulatory resident. The facility has a hospice waiver for five (5). There are currently zero (0) residents receiving hospice services. The facility is operating within the scope of their license.

The facility is a single-story home located in a residential area of Glendora. The home consists of living room, dining room, kitchen, 6 resident bedrooms, 3 bathrooms, laundry area and attached garage. The backyard has a newly constructed, vacant, ADU.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to residents, were observed to be inaccessible to residents.