Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the required annual inspection. LPA arrived unannounced and met with Staff. The reason for the visit was explained. Administrator, Florentino Vitangcol, arrived shortly after to assist with the visit. The facility is licensed for six (6) adults, ages 18 - 59, of which 2 may be non-ambulatory. There are currently (5) individuals residing at the facility and were placed by the San Gabriel/Pomona Regional Center.

LPA inspected the facility using the Compliance and Regulatory Enforcement (CARE) tools.

The facility consists of 4 client bedrooms (2 shared and 2 private), 2 bathrooms, living room, dining area, and kitchen. There is a separate laundry room. The bedrooms have the appropriate furniture, storage space, and lighting. Extra linens and hygiene supplies are observed. Facility has interconnected smoke detectors and a carbon monoxide detector located in the kitchen. Knives and cleaning solutions and disinfectants are locked. There are sufficient food supplies of 2 day perishable and a week of non-perishable items. The hot water temperature was measured between the required range of 105-120 degrees F. Staff are providing care and supervision to meet the clients' needs. There is an awake staff in the overnight shift. Staff are continuing to follow their infection control plan and procedures while handling clients. Staff are all fingerprint cleared and associated to the facility. LPA reviewed records for 3 staff. The administrator's certificate expires on 10/22/26 and the HIV & TB certificates are still valid. Staff have current CPR & First Aid certificates and have CPI training. LPA reviewed 6 client files and the P&I funds. Files are complete with the required documents. Medications are being administered as prescribed. The Emergency Disaster Plan is updated and conducting disaster drills.

No deficiencies were given today. An exit interview was held and a copy of this report was given to the administrator.