Facility Evaluation Report

Licensing Program Analysts (LPAs) Daniel Konishi and Gabriela Castro conducted the unannounced Annual Inspection visit using the Compliance And Regulatory Enforcement (CARE) Tool. LPA met with S1 and the purpose of the visit was discussed.

The following 9 (CARE) tool domains were observed and reviewed: Infection Control, Physical Plant/Environment Safety, Operational Requirements, Staffing, Client Rights/Information, Food Service, Health Related Services, Disaster Preparedness, and Emergency Intervention.

Infection Control: LPA observed the facility has sufficient PPE supplies. Infection Control Plan is in place. The plan was collected and reviewed.

Physical Plant and Environmental Safety: The facility is licensed to serve (4) clients of ages between 18-59. (1) AMBULATORY & (3) NON-AMBULATORY, OF WHICH 3 MAY BE BEDRIDDEN. Bedridden clearance for rooms #2-#4 There are currently (3) clients who were placed by the San Gabriel Pomona Regional Center. Facility is located in a residential area and consist of a living room, kitchen, dining area, office space, attached garage/laundry, 4 client bedrooms and 2 bathrooms. The facility was inspected during the physical plant tour. No passageways or paths were obstructed in Indoor and outdoor areas. Fire Extinguishers are fully charged and last inspected on 11/19/2024. Carbon Monoxide detectors were tested and working properly.