Facility Evaluation Report

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Required- 1 year visit. LPA contacted the administrator, Jose Alderete on the phone as no one was home upon arrival. At 10:30am, LPA met with the administrator and explained the purpose of the visit. The facility is licensed to care for (3) Developmentally Disabled Adults, ages 18 through 59, (2) ambulatory and (1) non ambulatory only. 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: Infection control practices and Personal Protective Equipment (PPEs) were observed. Bathrooms have hand washing signs, soap and paper towels. Staff are adhering to infection control requirements.

Physical Plant/Environment Safety: The interior and exterior physical plant was inspected. The facility is a single story home with (4) bedrooms of which (3) are client bedrooms and (1) for an office, (2) full bathrooms, a living room/activity area with covered fireplace, kitchen, dining area, backyard, and an attached garage. Client bedrooms were toured and each bedroom has a smoke detector, bed, linen, dresser, light, chair and sufficient closet space. Bathrooms have liquid soap and toilet paper. Kitchen knives, sharps objects are locked and inaccessible to clients. There is a fire extinguisher mounted on the kitchen wall, purchased on 10/25/2024 and s taff purchased a new fire extinguisher. Smoke alarms and carbon monoxide were tested and operable. Exit doors are free of any obstruction and there are no pools or large bodies of water. Backyard was inspected and has a shaded area and sitting area. Attached garage was inspected. There are no firearms or weapons stored at the facility. Hot water temperature readings measured within the required 105 - 120 degrees Fahrenheit. Hot water supply measured 108.9 deg F in bathroom #1.

Operational Requirements: The facility has an Infection Control and Response Plan. Surety Bond in the amount of $2000 is valid, expired on 03/23/202 8. Last fire drill was conducted on 05/10/2026.