Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Irra conducted the required annual inspection. LPA met with Jeremiah Daniels and discussed the purpose of today’s visit.

This home consists of (3) bedrooms, (2) bathrooms (one of which is located inside the office), living room, office, kitchen, dining area, laundry room and a detached garage. San Gabriel Pomona Regional Center provides case management services for all clients residing at this facility.

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: The smoke detectors were tested and all are operable. The carbon monoxide detector (combination with smoke detector) is located in the hallway (tested and operable). The fire extinguisher was observed near the dining table and appeared to be full (last service date of 01/27/25). Hot water supply measured at 110.8* in the hallway bathroom. Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients. Passageways were free of obstruction.

Staffing : There is sufficient staffing at the facility. Staff employed are over the age of (18) and are fingerprint cleared and associated to the facility.

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