Facility Evaluation Report

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

This home consists of the following: (4) private client bedrooms (each client has their own private bedroom), (2) full bathrooms, living room, kitchen, dining area, laundry room and has an attached garage. San Gabriel Pomona Regional Center provides case management services for all clients residing at this home.

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. There are using appropriate hand hygiene and wearing gloves while assisting clients. Staff are cleaning and disinfecting often for high touched surfaces.

Operational Requirements: Staff are adhering to operational requirements.

Physical Plant & Environment Safety: Smoke alarms and carbon monoxide detector were tested and are operable. Fire extinguishers observed and appeared to be full (1 in the kitchen and 1 in the hallway) . Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients.

Staffing : There is sufficient staffing at the facility. Administrator Certificate on file for Jorge Romero expires on 11/16/2023 Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility.

Personnel Records-Training : LPA reviewed staff files for Staff #1 (S-1) and Staff #5 (S-5). Staff have current First Aid/CPR certification. Staff have their Health Screening and Tuberculosis Screening on file.

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