Facility Evaluation Report

Licensing Program Analyst (LPA) Wong conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA met with DSP Veneranda Guiyab and explained the reason of the visit. The facility is approved for serve for four (4) Developmentally Disabled Adults ages 18-59, approved for ambulatory only. The facility is licensed as a Level 3 home vendored by San Gabriel Pomona Regional Center.

The following twelve (12) tool domains were observed and reviewed: Infection Control, Physical Plant/Environmental Safety, Operational Requirements, Staffing, Personal Records-Training, Client Rights/Information, Client Records/Incident Reports, Food Service, Health Related Services, Incidental Medical Services, Disaster Preparedness and Emergency Intervention.

1. Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. The facility still encourages hand washing, checking clients and visitor temperature , and staff disinfected the facility every shift or as needed and visitor screening and mask wearing. The facility also has sufficient PPE supplies. The facility has an Infection Control Plan and COVID-19 mitigation plan in place.

2. Physical Plant and Environmental Safety: The facility is a single story house and located in a residential neighborhood area. The facility includes: living room, dining area, staff office, kitchen, two bathrooms, three clients bedrooms, staff break room and an attached garage. Bedroom#1 and #2 has one bed, one night stand, one chair, required bed linen and furniture and sufficient lighting and closet space. Bedroom#3 has two beds, two chairs, two night stands and required bed linen and furniture and sufficient lighting and closet space. The two clients bathrooms are clean, sanitary and in a good working condition. The hot water temperature tested in both bathrooms were 108.5 and 109 degrees F. which are within the Title 22 regulation. All the appliances in the kitchen and living room are working properly. The sharp knives and utensils are stored and locked in the kitchen drawer.