Facility Evaluation Report

Licensing Program Analyst (LPA) Christian Gutierrez conducted the annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA met DSP worker Marissa Casuga at approximately 11:55 AM and explained reason for visit. House Manager Telebrico Leilani was notified by telephone.

The facility is licensed to serve as an Adult Residential Facility for 6 (6) non- ambulatory clients in the age range of 18 through 59. All clients are serviced by San Gabriel Pomona Regional Center. This is a single-story home located in a residential neighborhood. It consists of the following: 4 client bedrooms, 2 staff rooms, 2 client bathrooms, 1 full staff bathroom, living/dining room area, kitchen, detached garage, outside closet room, backyard, and front yard with patio furniture.

LPA toured the facility and observed the following: Each client bedroom has the required furniture and bedding. There is extra clean linen and towels in hallway closet. Smoke detectors/carbon monoxide detectors were observed in each room and throughout the facility and are properly operating. The facility has one (1) fully charged fire extinguishers which is kept in living room. Cleaning supplies and toxic substances are inaccessible to clients locked outside closet room. LPA observed sharps in kitchen drawer with no lock deficiency cited. Freezers are maintained at a temperature of 0-degree F and the refrigerators at a maximum of 45 degrees F. Sufficient supply of 2 days perishable & 7 days non-perishable foods was observed in the kitchen. There are no firearms or weapons stored at the facility. The hot water temperature in the bathrooms were measured between the required range of 105-120 degrees F. The facility does not have a swimming pool or bodies of water on the premises There is a shaded seating area for the residents located in the backyard. Passageways and exits are free of obstruction.