Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Irra conducted an unannounced Required-1 year visit focusing on COVID-19 Infection Control Practices. LPA met with S'halana Carter and discussed the purpose of today's visit.

This home consists of (4) bedrooms, (2) bathrooms, living room, kitchen, dinning area and attached garage. Each client has their own bedroom. All Clients residing at this facility receive case management services provided by San Gabriel Pomona Regional Center.

COVID-19 Infection Control Practices (including signs) were observed at the entrance of this facility and throughout the facility.

Signs are posted to promote hand washing, cough/sneeze etiquette, and physical distancing were observed.

Restrooms have hand soap and paper towels.

Sufficient supply of perishable for 2 days and non-perishable foods for 7 days were observed.

Medication reviewed for (2) Clients (C-1 through C-2).

Staff responsible for direct care and supervision will wear masks.

Clients socially distance according to local public health guidelines.

Exit interview conducted, a copy of this report and Appeal Rights were provided to S'halana Carter.

Note; LPA was experiencing technical difficulties during today's visit.