Facility Evaluation Report

Licensing Program Analysts (LPAs) Elizabeth Irra and Mayra Cota conducted the required annual inspection. LPA met with Jesenia Flores (S-1) and discussed the purpose of today’s visit.

This home consists of (4) bedrooms, (2) bathrooms, kitchen, dining area, living room, storage/laundry room and attached garage. San Gabriel Pomona Regional Center provides case management services to all clients from this home. Fire Department cleared/approved (4) ambulatory and (2) non-ambulatory (Total capacity of 6).

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 (located near the kitchen) tested and operable. Fire extinguisher was last serviced on 03/06/24 and is located near the kitchen. Last fire drill was conducted on 12/02/24. Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients. Hot water temperature measured at 111.9* in the hallway bathroom and 118.3* in the bathroom located inside bedroom #1.

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