Facility Evaluation Report

Licensing Program Analyst (LPA) Wong conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA met with DSP Aura Alarcio and Yanet Saidana and explained the reason of the visit. The facility is approved for serve Developmentally Disabled, age range 18-59 and 4 ambulatory only. The facility is licensed as a 4I home vendored by San Gabriel Pomona Regional Center.

The following twelve (12) tool domains were observed and reviewed: Infection Control, Physical Plant/Environmental Safety, Operational Requirements, Staffing, Personal Records-Training, Client Rights/Information, Client Records/Incident Reports, Food Service, Health Related Services, Incidental Medical Services, Disaster Preparedness and Emergency Intervention.

1. Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. The facility still encourages hand washing. The facility has an Infection Control Plan and COVID-19 mitigation plan in place.

2. Physical Plant/Environmental Safety: The facility is a single story house and located in a residential neighborhood area. The facility includes living room, kitchen, dining area, staff office, four clients bedrooms, two clients bathrooms and an attached garage. Each client room has one bed, one chair, one night stand, one drawer and required beddings and sufficient lighting and closet space. The two clients' bathrooms are clean, sanitary and in a workable condition. The hot water temperature in two clients bathrooms are tested 105 degrees F which are within Title 22 regulation. All the sharp knives, utensils, chemicals and cleaning supplies are stored and locked under the sink. All the appliances in the kitchen and living room are working well. LPA inspected smoke detectors and carbon monoxide detectors are all working probably. The extra personal hygienes are stored in the garage. The extra linen and towels are stored in the hallway closet. The facility would turn on the hallway light at night so client can passage to nonprivate bathrooms. The facility has a land-line telephone system.