Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Irra conducted the required annual inspection. LPA met with Wilfredo Cruz/S-1 and discussed the purpose of today’s visit.

This single family home which consists (6) bedrooms, (2) bathrooms, living room, family room, kitchen, dining area and an attached garage. This home has fire clearance for (4) non-ambulatory in bedrooms #2 and #3 and (2) ambulatory clients. All clients from this home receive case management services provided by San Gabriel Pomona Regional Center.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: There are using appropriate hand hygiene and wearing gloves while assisting clients. Staff are cleaning and disinfecting often for high touched surfaces. Facility has an Infection Control Plan in place.

Operational Requirements: Last Disaster Drill was conducted on 02/23/23. Staff are adhering to operational requirements.

Physical Plant & Environment Safety: Smoke alarms were tested and operable. Fire extinguisher is located in the kitchen and was last serviced on 03/08/23. Carbon monoxide detector is located in the kitchen (tested and operable). Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients. Water temperature measured at: 110.0*.

Refer to LIC 809C for the continuation of this report.