Facility Evaluation Report
Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced Required 1-year visit using the Infection Control Evaluation Tool. LPA met with Administrator Loveday Chinaka and explained the reason for the visit. Physical plant was toured, clients’ files, medication records, staff files and food supply were all reviewed. The facility is approved for four (4) ambulatory developmentally disabled adults, ages 18-59. The facility currently has two (2) approved Age Exceptions on file. There are currently three (3) clients residing in this facility and receive case management services provided by San Gabriel/Pomona Regional Center.
The facility is single story home located on a residential street. The front yard of the facility is unfenced and well maintained. The facility consist of four (4) client bedrooms, two (2) full bathrooms, kitchen, dining area, living room, staff office, fenced backyard and attached garage. LPA observed a shaded seating area for clients in the backyard. All client bedrooms were toured. Bedroom(s) #1, #2, #3, #4 all contained a bed, linen, dresser, chair, light, and sufficient closet space. Bedroom #4 is unoccupied. LPA observed non-skid mats in both bathrooms. Bathroom #1 water temperature was tested at 110.4 degrees and was stocked with soap and paper towels. Bathroom #2 water temperature was tested at 112.3 degrees and was stocked with soap and paper towels. Fire extinguisher located in the kitchen was verified on 10-31-22. LPA tested the water in kitchen at 118.0 degrees which is within the required 105-120 degrees. LPA observed the refrigerator to have the sufficient required 2-day perishable and 7-day nonperishable. Cleaning supplies, and sharps were observed to be locked in a cabinet located in the garage which is inaccessible to clients. LPA observed more than a 30-day supply of PPE located in the garage.
LPA reviewed three (3) client records to confirm updated emergency contacts, medications records and updated health screenings on file. Eight (8) staff records reviewed to confirm health screenings, current First Aid/CPR certification, fingerprint clearance, Criminal Record Statement, and Infection Control Training. Medications are documented and stored in a locked cabinet located in the staff office.
No deficiencies were observed. LPA conducted exit interview and will email report to administrator.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction