Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the unannounced annual inspection. LPA met with Staff, Keith Colder, and explained the purpose of the visit. The facility is licensed to serve (4) non-ambulatory clients, ages 18 through 59. This facility is vendorized by the San Gabriel/Pomona Regional Center.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today.

The facility is a single-story home with four (4) individual client bedrooms, one (1) staff room, one (1) Staff office, three (3) bathrooms, kitchen, dining room, living room, and attached garage. Bedrooms have required furniture and storage space. There are no pools or bodies of water on the premises. Knives and cleaning solutions are locked and inaccessible to clients. The water temperature was measured within the required range of 105-120 degrees F. Sufficient food supplies were observed. Staff are adhering to operational requirements.

LPA reviewed (3) personnel files. The Administrator's certificate expired on 12/2/26 and the HIV & TB certificates were issued on 4/22/25. Staff have current First Aid & CPR certification. LPA reviewed files all three (3) Clients and their medications. The files have the required documentation and staff are administering the medications as prescribed. The facility uses the Medication Administration Record (MAR) log to document medications given. There are no clients with a restricted health condition or using any postural support. Facility has an Emergency Disaster Plan and conducting drills at least quarterly.

No deficiency was issued today. An exit interview was held. A copy of this report and appeal rights were given to Staff K. Colder.