Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Irra conducted the required annual inspection. LPAs met with Wilfredo Cruz. LPA explained 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 (CARE) tools for the visit today and observed the following:

Infection Control: Facility has an Infection Control plan in place.

Operational Requirements: Staff are adhering to operational requirements.

Physical Plant & Environment Safety: Smoke alarms were tested and operable. Carbon monoxide detector was tested and operable (located in the kitchen). The fire extinguisher observed in the kitchen and appeared to be full (last service date: 03/13/25). Hot water temperature measured between:108.9* to 109.5*. Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients. Passageways were free of obstruction.

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