Facility Evaluation Report

Licensing Program Analyst (LPA) Glenn Trueman conducted the unannounced annual inspection using the Compliance and Regulatory Enforcement (CARE) Tools. LPA met with DSP Eliazar Medina and explained the reason of the visit.The facility is approved for six (6) non-ambulatory Developmentally Disabled Adults. The facility is vendorized by the San Gabriel Pomona Regional Center. There are currently (4) clients residing at the facility.

The facility is a single story house consisting of (3) shared client bedrooms, 2 bathrooms, living room, dining area, kitchen, and a garage. Each client bedroom has the appropriate furniture and closet space. Sharps and knives are locked in the kitchen drawer. Cleaning supplies are also inaccessible to clients. The smoke and carbon monoxide combo detectors are operable. Extra linens and hygiene supplies are observed. The hot water temperature is measured within the range of 105-120 degree F. LPA observed sufficient food supplies of 2-day perishables and a week of non-perishables. No items obstructing the walkways. The backyard has a shaded area with a table and chairs for client use.

LPA reviewed (7) personnel files. The administrator's certificate expires on 5/9/28. The CPR and First Aid certificates are current for all 7 staff. Staff have background clearance and associated to the facility. LPA reviewed all (4) client files and their medications. The files have the required documents and medications are given as prescribed. Medications are centrally stored and locked in the hallway cabinet.

Facility has the updated Emergency Disaster Plan and is conducting quarterly drills. Last drill was conducted on 5/24-26.

LPA did not issue any deficiencies, however, technical advisories were given. An exit interview was held and a copy of this report was given to DSP Eliazar Medina.