Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Irra conducted the required annual inspection. LPA met with Nicole Lian and discussed the purpose of today’s visit.

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

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 08/16/23. Staff are adhering to operational requirements.

Physical Plant & Environment Safety: Carbon monoxide detector was tested and is operable. Fire extinguisher observed near the kitchen (last serviced 01/10/23). Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients. Water temperature measured as follows: 107*.

Staffing : There is sufficient staffing at the facility. Administrator Certificate on file for Nicole Lian expires 01/25/25. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility.

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