Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the required annual inspection on 6/3/25. LPA met with Staff, Jossen Maglalang, and explained the purpose of the visit. Administrator, Anthony Ngo, arrived shortly after to assist with the visit. The fire clearance is approved for 6 residents, ages 60 and over, of which 2 may be non-ambulatory. There are 6 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.

Facility is continuing to follow their Infection Control plan. Staff are wearing gloves to assist residents. The facility is a single story home with 3 resident bedrooms, 1 staff room, 2 bathrooms, living room, dining area, family room, and kitchen. The laundry machines are located in the garage. The fireplace is secured with a cover. There is no swimming pool on the premises. Bathrooms have non-skid mats in the shower area and grab bars. Knives, cleaning solutions, and disinfectants are locked. The hot water temperature was measured between the required range of 105-120 degrees F. Sufficient food supplies of 2 day perishable and at least a week of non-perishable are observed. The kitchen is kept clean and sanitary. There is sufficient space to accommodate indoor and outdoor activities. LPA reviewed 3 staff files. Administrator's certificate expires on 12/25/26. Staff have current CPR & First Aid certificates and are receiving annual training. LPA reviewed 6 resident files and they have the required documents. There are currently no residents with a prohibited or restricted health condition or using oxygen. Medications are centrally stored and locked. All the residents are given their medications as prescribed by the physician. The facility uses a Medication Administration Record (MAR) log to mark when given. The Complaint poster, Local Ombudsman, and Residents personal rights are posted. The Emergency Disaster Plan is posted and reviewed annually by the administrator. Disaster drills are conducted at least quarterly.

No deficiency was issued today. An exit interview was held and a copy of this report was given to Staff Langa.