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

LPA conducted a facility tour. This home consists of (6) private client bedrooms, (3) bathrooms, living room, kitchen, dinning area, exercise/laundry room. San Gabriel Pomona Regional Center provides case management services for all (6) clients residing at this facility.

COVID-19 Infection Control Practices (including signs) were observed throughout the facility.

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

PPE supplies observed inside a large storage chest.

Hygiene and incontinence supplies observed.

Restrooms have hand soap, hand sanitizer and paper towels. Hand washing signs were observed posted in all (3) bathrooms.

Sufficient supply of perishable for 2 days and non-perishable foods for 7 days were observed. Facility has (2) refrigerators that are fully stocked.

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

Per S-1, all (6) clients are fully vaccinated including the booster vaccine.

Per S-1, all clients have their annual flu vaccine pending.

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 Nicole Lian/S-1.