Facility Evaluation Report

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

This home consists of (3) bedrooms, (2) bath, living room, family/t.v. room, kitchen, dining area and attached garage. All clients receive case management services provided by San Gabriel Pomona Regional Center. Fire Clearance is for (6) ambulatory clients.

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 07/12/23. Staff are adhering to operational requirements.

Physical Plant & Environment Safety: Smoke alarms were tested and operable. Fire extinguisher is located in the kitchen and appeared to be full. Carbon monoxide detectors are located in the dining room and near the entrance door (tested and operable). Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients. Water temperature measured at: 112.1*.

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