Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Irra conducted the required annual inspection. LPA was allowed entry by Jessica Rodriguez/S-1. LPA explained the purpose of today's visit. Jeffrey Vitangcol (Facility Administrator) arrived at approximately at 1110 A.M..

Facility is a single story home located in a residential area. This home consists of (4) bedrooms, (2) bathrooms (1 of which is located inside bedroom #3), living room, kitchen, dining area, laundry section (hallway) and attached garage. 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: There are using appropriate hand hygiene and wearing gloves while assisting clients. Staff are cleaning and disinfecting often for high touched surfaces. Facility has sufficient PPE supplies, has an Infection Control Plan and Mitigation Plan. Facility has COVID-19 signage posted throughout the facility. Bathrooms have hand washing signs, soap and paper towels. Staff are adhering to infection control requirements.

Operational Requirements: The fire clearance is approved for (4) ambulatory clients. Last Fire Drill and Earthquake Drill were conducted 03/02/2023. Staff are adhering to operational requirements.

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