Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Irra conducted an unannounced Required- 1 year visit focusing on COVID-19 Infection Control Practices. LPA met with Licensee and explained the purpose of the visit.

This is a single story home with 3 bedrooms, 1 office, 2 bathroom kitchen with dinning area, living room and an attached garage. All clients receive case management services provided by San Gabriel Pomona Regional Center.

COVID-19 Infection Control Practices (including signs) were observed at the entrance of this home, in all common rooms and hallways.

Medications for (3) clients were reviewed.

Signs are posted throughout the facility to promote hand washing, cough/sneeze etiquette, and physical distancing.

Sufficient supply of perishable for 2 days & non-perishable foods for 7 days were observed.

PPE supplies inspected. Additional supply warranted. Advisory note provided.

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