Facility Evaluation Report

Licensing Program Analyst (LPAs) Elizabeth Irra conducted the required annual inspection. LPA was allowed entry to the home by Maria Teresa De Ungria. LPA discussed the purpose of today’s visit. Cynthia Tuason (Administrator) arrived at approximately 11:10 A.M..

This home consists of (5) bedrooms (3 of which are client occupied), (2) bathrooms, living room, kitchen, dining area, recreation room, laundry set-up is inside the attached garage. All Clients residing at this facility receive case management services provided by San Gabriel Pomona Regional Center. This facility is approved for (6) ambulatory clients.

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 tested and operable. Fire extinguisher was last serviced on 12/20/24 (located in the kitchen). Last fire drill was conducted on 09/02/24. Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients. Hot water temperature measured at 109.0* (hallway) and 110.0* in the bathroom inside bedroom #4.

Staffing : There is sufficient staffing at the facility. 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.