Facility Evaluation Report

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

This is a single home with 4 bedrooms, 2 bathrooms, living room, kitchen, dining area with an attached garage. All (3) 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 an Infection Control Plan in place.

Operational Requirements: The fire clearance is approved for (4) non-ambulatory clients. Last Disaster Drill was conducted on 04/21/23. Staff are adhering to operational requirements.

Physical Plant & Environment Safety: Smoke alarms were tested and operable. Fire extinguisher is located in the living room with a purchase receipt dated 04/06/23 and appeared to be full. Carbon monoxide detector is located in the living room (tested and operable). Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients. There are no firearms or weapons stored at the facility. Hot water supply measured at: 112.2* in both bathrooms.

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