Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Irra conducted the required annual inspection. LPA was allowed entry by Brandon Hampton/S-1. LPA explained the purpose of today's visit.

The facility is licensed for (4) ambulatory clients ages 18 through 59. The fire clearance is approved for (4) ambulatory clients. All clients residing at this home receive case management services provided by San Gabriel Pomona Regional Center. This is a single story home that consists of (4) bedrooms, (2) bathrooms, living room, kitchen, dining room, activity room and an attached garage (laundry unit is set-up inside the garage).

LPA utilized the Compliance and Regulatory Enforcement (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 and carbon monoxide were tested and are operable. Fire extinguisher is located in the kitchen (last serviced 12/29/23). Last fire/earthquake drill was conducted 03/04/24. Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients.

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.