Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Irra conducted the required annual inspection. LPA met with Susan Garcia and discussed the purpose of today’s visit. Larry Goodman arrived at approximately 11:45 A.M..

This home consists of (3) bedrooms, (1) bathroom, kitchen, dining area, living room and an attached garage. This home is approved for (6) ambulatory clients. All clients residing at this home 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: 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. Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients. Hot water temperature measured at 106.0*.

Staffing : There is sufficient staffing at the facility. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility.

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