Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Irra conducted the required annual inspection. LPA met with Rizalina Gaeta/S-1 and discussed the purpose of today’s visit.

This home consists of 4 bedrooms, 2 bathrooms, living room. kitchen and dining room. All clients receive case management services provided by San Gabriel Pomona Regional Center. Fire Clearance is for (4) ambulatory clients.

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: Last Disaster Drill was conducted on 02/10/23. Staff are adhering to operational requirements.

Physical Plant & Environment Safety: Smoke alarms were tested and operable. Carbon monoxide detector was tested and is operable. Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients. Water temperature measured at: 114.5* in bathroom between bedroom #1 and bedroom #2 and 113.9* in the hallway bathroom.

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