Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Irra conducted the required annual inspection. LPA was allowed entry by Millie Stewart. LPA discussed the purpose of today's visit.

The facility is licensed for (4) ambulatory clients ages 18 through 59. The fire clearance is approved for (4) 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: Facility has an infection control plan in place.

Operational Requirements: The fire clearance is approved for (4) ambulatory clients. Last Fire Drill and Earthquake Drill were conducted on 09/30/23. Staff are adhering to operational requirements.

Physical Plant & Environment Safety: This facility consists of (3) bedrooms (1) bathroom, living room, den/tv room, kitchen, dining area, laundry area and attached garage. Smoke alarms were tested and operable. Fire extinguisher appeared to be full and was last serviced on 01/23/24. Carbon monoxide tested and operable. Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients.

Staffing : There is sufficient staffing at the facility. Administrator Certificate for Millie Stewart expires on 07/07/25. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility.

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