Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Irra conducted the required annual inspection. LPA met with Alice Reyes/Facility Quality Assurance Staff. LPA explained the purpose of today's visit. Elizabeth Stacy arrived at approximately 11:10 A.M..

This is a single story home which consists of (3) bedrooms, (2) bathrooms, living room, kitchen, dinning area, laundry room (inside the garage) and attached garage. All Clients residing at this facility receive case management services provided by San Gabriel Pomona Regional Center.

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 sufficient PPE supplies, has an Infection Control Plan and Mitigation Plan. Facility has COVID-19 signage posted throughout the facility. Bathrooms have hand washing signs, soap and paper towels. Staff are adhering to infection control requirements.

Operational Requirements: The fire clearance is approved for (4) ambulatory clients and (2) non-ambulatory clients in bedroom #1. Last Fire Drill and Earthquake Drill were conducted 03/252023. Staff are adhering to operational requirements.

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