Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Irra conducted an unannounced Required- 1 year visit focusing on COVID-19 Infection Control Practices. LPAs met with S-1 and explained the purpose of the visit. There are (6) clients residing at this home. All clients receive case management services provided by San Gabriel Pomona Regional Center.

COVID-19 Infection Control Practices (including signs) were observed at the entrance of this home, in all common rooms and hallways.

Medications for (6) clients were reviewed for Client #1 through Client #6 (C-1 through C-6).

Signs are posted throughout the facility to promote hand washing, cough/sneeze etiquette, and physical distancing.

Clients were socially distanced according to local public health guidelines.

Staff responsible for direct care and supervision were observed wearing masks.

Sufficient supply of perishable for 2 days & non-perishable foods for 7 days were observed. There are additional supplies stored inside the garage.

Sufficient PPE supply observed. There are additional supplies stored inside the garage. Hand sanitizer observed throughout the common areas of this facility.

Exit interview conducted, a copy of this report and Appeal Rights were provided to S-1