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 Jesenia Flores and discussed the purpose of today's visit.

This home consists of (4) bedrooms, (2) bathrooms, kitchen, dinning area, living room, storage/laundry room and attached garage. San Gabriel Pomona Regional Center provides case management services to all (4) clients from this home.

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

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

Restrooms have hand soap, hand sanitizer and paper towels. Hand washing signs are also posted inside the bathrooms.

Hand sanitizer observed throughout the home.

Sufficient supply of perishable for 2 days and non-perishable foods for 7 days were observed. Additional food supply is stored inside the garage.

Medication reviewed for (4) Clients (C-1 through C-4).

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 Jesenia Flores.