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 S-1 and explained the purpose of today's visit.

This home consists of (6) private client bedrooms, (3) bathrooms, living room, kitchen, dinning area, exercise/laundry room. All Clients residing at this facility receive case management services provided by San Gabriel Pomona Regional Center. LPA toured grounds.

COVID-19 Infection Control Practices (including signs) were observed at the entrance of this facility and throughout the facility.

Signs are posted to promote hand washing, cough/sneeze etiquette, and physical distancing were observed.

Restrooms have hand soap, hand sanitizer and paper towels.

Sufficient supply of perishable for 2 days and non-perishable foods for 7 days were observed. This facility has (2) refrigerators.

Per Administrator, all (6) clients are fully vaccinated including the booster vaccine.

Per Administrator, all staff are fully vaccinated and some staff are pending the booster.

Per Administrator, all clients and staff have received their flu vaccine.

Medication reviewed for (6) Clients (Client #1 through Client #6).

Staff responsible for direct care and supervision will wear masks.

Clients were be socially distanced according to local public health guidelines.

Exit interview conducted, a copy of this report and Appeal Rights were provided to S-1