Facility Evaluation Report

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA was met by Renee Rodriguez Direct Service Professional I (DSPI) and Sandra Soltero, Care Staff and explained the purpose of the visit. At 10:25am, Administrator Ricardo Montes arrived and at 11:35am, another Administrator, Genny Guadalquivir arrived and assisted LPA with the inspection. The facility is licensed to care for four (4) Developmentally Disabled Adults, ages 18 through 59, (3) ambulatory only and (1) ambulatory clients. All clients residing at this facility receive case management services provided by San Gabriel Pomona Regional Center. LPA observed the following:

Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. There is a visitor sign-in station located near the front door. LPA observed a staff using gloves while cleaning. The facility has submitted a COVID-19 Mitigation Plan and Infection Control Plan. Staff are adhering to infection control requirements.

Operational Requirements: A current Plan of Operation was reviewed. The Infection Control Plan has been added to the Plan and submitted to CCL. Surety Bond is in effect with bond amount of $3000 and expires on 11/01/2024. Fire/Disaster Drill was last conducted on 03/22/2024.

Physical Plant/Environment Safety: The facility is a single storey home located in a residential neighborhood, contains three (3) client bedrooms, two (2) full bathrooms, living room, kitchen, dining area, den, backyard, and detached garage. Currently, there are four (4) clients living in the facility. Facility is a Level 4I. The interior and exterior physical plant was inspected. Client bedrooms were toured. Each bedroom has a smoke detector, bed, linen, dresser, night stand, light, chair and sufficient closet space. Bathrooms have non-skid materials and contained hygiene supplies including liquid soap, paper towels, and toilet paper. The sink in bathroom #2 is clogged. Exit doors are free of any obstruction and there are no pools or large bodies of water. Backyard was inspected and LPA observed that the outside furniture did not have a patio umbrella. Detached garage was inspected and there is an extra refrigerator/freezer to stock up additional food items. Kitchen knives, sharps objects, are kept locked in a kitchen drawer. The cleaning supplies and toxic substances are stored in a cabinet under the sink which is also kept locked and inaccessible to clients. The facility has a fireplace in bedroom #3 which was screened and inaccessible to clients. There is one (1) fire extinguisher observed mounted on the kitchen wall which was last serviced on 02/01/2024. Smoke alarms and carbon monoxide were tested and operable. There are no firearms or weapons stored at the facility . Water temperature readings were within the required 105-120 degrees Fahrenheit. *****CONTINUED ON LIC809-C*****