Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Irra conducted the required annual inspection. LPA met with Millie Stewart (Administrator). LPA explained the purpose of today's visit.

This facility consists of (3) bedrooms (1) bathroom, living room, den/tv room, kitchen, dining area, laundry area and attached garage. 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 (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: The carbon monoxide detector and smoke detectors were tested and are operable. The fire extinguisher was observed in the living room (last serviced 01/27/25). Hot water supply measured 105.5*. Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients. Passageways were free of obstruction.

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