Facility Evaluation Report
Licensing Program Analyst (LPA) Cynthia Chan conducted the unannounced annual inspection on 1/28/26. LPA met with Staff, Rebecca Martinez, and informed the reason for the visit. Administrator, Victor Mora, arrived at 10:45am. The facility is licensed for four (4) adults, ages 18 to 59, ambulatory only. There are currently (2) ambulatory clients residing at the facility, and were placed by the San Gabriel/Pomona Regional Center.
LPA utilized the Compliance and Regulatory Enforcement (CARE) tools to inspect the facility today.
The facility consists of (4) bedrooms: 3 bedrooms for clients, 1 staff bedroom with a full bathroom, 1.5 bathrooms for client use, living room, additional staff room/storage, dining room, kitchen, pantry, laundry room, and a garage. The garage has a built in office space and is accessible through the exterior. There are no items obstructing the walkways. The backyard has a shaded area with a table and chairs. No swimming pool on the premises. The hot water temperature is measured within 105-120 degrees F. Knives and cleaning products are locked in the kitchen cabinets. Food supplies are sufficient. There is a carbon monoxide detector and smoke detectors throughout the home. The fire place is covered and not in use. Client rights and licensing poster are observed. LPA observed video surveillance in the common areas and requested for administrator to submit an addendum to the plan of operation and admission agreement.
LPA reviewed (2) client files. The files have the required documents. LPA reviewed one client's medication as the other is not prescribed any medications. There was no discrepancy observed. LPA reviewed (2) staff files. The administrator had sent in the documents for renewal and was received by the department on 12/31/25. The facility does not have the updated Emergency Disaster Plan and drills are not being conducted. LPA issued a deficiency and technical violations today.
An exit interview was held. A copy of this report and appeal rights were given to the administrator.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction