Facility Evaluation Report

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

This home consists of (3) bedrooms, (2) bathrooms, kitchen, dining area, den/game room, living room and attached garage. All clients residing at this facility receive case management services provided by San Gabriel Pomona Regional Center. This facility is approved for (4) ambulatory clients. Currently, each client has their own bedroom.

LPA utilized the Compliance and Regulatory (CARE) tools for the visit today and observed the following:

Infection Control: Facility has an Infection Control Plan in place.

Operational Requirements: Staff are adhering to operational requirements.

Physical Plant & Environment Safety: Smoke alarms and carbon monoxide detector (are combined) tested and operable. Fire extinguisher is located in the kitchen and appeared to be full (last serviced 09/26/23). Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients.

Staffing : There is sufficient staffing at the facility. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility.

Personnel Records-Training : LPA reviewed staff files for Staff #1 (S-1) through Staff #4 (S-4). Staff have current First Aid/CPR certification. Staff have their Health Screening and Tuberculosis Screening on file.

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