Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the unannounced annual inspection. LPA met with Administrator, Tomasa Coronado, and explained the reason for the visit. The facility is licensed for four (4) clients, ages 18 through 59, of which two (2) may be non-ambulatory. The facility is vendorized by the San Gabriel/Pomona Regional Center.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools to inspect the facility.

The facility consists of 3 client bedrooms, 2 bathrooms, living room, dining room, den, kitchen, and an attached garage. The client bedrooms have the appropriate furniture and storage space. The fireplace is secured with a fence. Sufficient food supplies of two days of perishables and a week of non-perishables are observed. Knives and cleaning supplies are locked. The hot water temperature was measured within the range of 105-120 degrees F. There are no objects obstructing the walkways. A shaded area with chairs is provided in the back yard.

Medications are centrally stored and locked in the kitchen cabinet. LPA reviewed medications for all 4 clients and staff are administering the medications as prescribed. There is one client with a restricted health condition and a home health nurse administers the insulin. LPA reviewed 4 client files, and they are complete. LPA reviewed 3 staff files. The administrator's (Tomasa Coronado) certificate expires on 5/19/26. The HIV and TB certificates are current. Staff have current CPR & First Aid training and are receiving on-going training. The Emergency Disaster Plan is being reviewed annually, and facility is conducting emergency drills at least quarterly for each shift.

No deficiencies were observed today. An exit interview was held and a copy of this report was given to the administrator.