Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Irra conducted an unannounced Required-1 year visit focusing on COVID-19 Infection Control Practices. LPA was allowed entry by Brenda Seaborn and explained the purpose of today's visit.

This home consists of (5) bedrooms, (3) bathrooms, living room, kitchen, dinning area and office. All clients residing at this home receive case management services provided by San Gabriel Pomona Regional Center.

COVID-19 Infection Control Practices (including signs) were observed. Signs are posted throughout the facility to promote hand washing, cough/sneeze etiquette, and physical distancing.

Bathrooms have hand washing soap, paper towels and hand washing etiquette signs.

Medication reviewed for Client #1 (C-1) and Client #2 (C-2).

Per Facility Administrator, all staff and clients are fully vaccinated (including all boosters).

Sufficient supply of perishable for 2 days and non-perishable foods for 7 days were observed. There is an additional freezer with food supply.

PPE supplies observed. Additional supplies are stored inside the office.

Hygiene supplies observed. Additional supplies are stored inside the hallway closet.

Staff responsible for direct care and supervision were observed wearing masks.

Clients socially distance according to local public health guidelines and wear masks.

Exit interview conducted, a copy of this report and Appeal Rights were provided to Brenda Seaborn.