Facility Evaluation Report

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

This home consists of (4) bedrooms, 2 full-bathrooms, kitchen, dining area, living room, laundry room, office and an attached garage. This home has fire clearance for (2) non-ambulatory and (2) ambulatory clients. All clients residing at this home receive case management services provided by San Gabriel Pomona Regional Center.

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 extinguishers were observed (1) in the kitchen, (1) in the hallway and (1) in the laundry room (last serviced: 03/24/23). Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients. Water temperature measured as follows: 106.0*

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