Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced Annual Required Visit on 12/21/2023. LPA Ramirez was met by Co-Administrator Yvette Ramirez and explained the purpose of the visit. The facility is approved for three (3) ambulatory developmentally disabled adults, ages 18-59. There are currently 2 clients residing in this facility and receive case management services provided by San Gabriel/Pomona Regional Center.

LPA OBSERVATIONS: The facility is a single-story dwelling located on a main street. The facility consists of three (3) client bedrooms, two (2) bathrooms, kitchen, dining room, living room, front yard, backyard and attached garage.

Front Yard: LPA Ramirez observed front yard to be free of hazards. Front yard was well maintained.

Kitchen: LPA Ramirez observed appliances to be in working order. LPA Ramirez observed sufficient 2 days of perishables and 7-day supply on non-perishables. LPA Ramirez observed a fully charger fire extinguisher nearby. Kitchen sink temperature was measured at 112.8-degree F. LPA Ramirez observed facility menu on refrigerator.

Dining Room/Living room: Dining room was observed to contain one table with four (4) chairs. Living room was observed to contain plenty of lighting. LPA Ramirez observed a fully charged fire extinguisher nearby. LPA Ramirez observed signage promoting cough and handwashing etiquette in this area. LPA Ramirez observed nearby thermostat to read 72 degrees F.

Linen Closet/Supply Closet: Observed to contain plenty linens, towels, and hygiene products.