Facility Evaluation Report

Licensing Program Analyst (LPA) Wong conducted the required annual inspection. LPA arrived unannounced and met with Administrator Anthony Ngo and Assistant Administrator Lara Langa who allowed the entry of the facility and also assisted with the visit. The purpose for the visit was explained. The facility is licensed for AGE RANGE 18 THROUGH 59. APPROVED FOR 6 AMBULATORY, OF WHICH 2 MAY BE NON-AMBULATORY. BEDROOM #2 APPROVED FOR NON-AMBULATORY. The facility is vendored as Level 3 home with San Gabriel Pomona Regional Center

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and here are the domains that LPA inspected:

1, Infection Control: T he facility has an updated infection control plan and the facility continue to practice hand washing and disinfecting the facility each shift and The facility has sufficient PPE supplies in the facility.

2. Physical Plant and Environmental Safety: The facility is a single story house and located in a residential neighborhood area. The facility includes: kitchen, living room, dining area, three client's bedrooms, one client bathroom, a staff break room, live in staff room with bathroom and attached garage but used as a storage room. Bedroom#1 and #3 has one bed, one chair, one drawer, required beddings and furniture and sufficient lighting and closet space. Bedroom#2 has two beds, chair, two drawers, required beddings and furniture and sufficient lighting and closet space. The client's bathroom is clean, sanitary and in a good working condition. The hot water tested at the client bathroom and kitchen are between 105.6 and 112.1 degrees F which is within the Title 22 regulation. All the kitchen appliances are working properly. The sharp knives and utensils are stored in the garage. The cleaning supplies and chemicals are stored and locked in the garage. The extra personal hygiene products are stored and locked in the garage cabinet. The hallway light will be on during night time for client to have access the non-private bathroom. The facility has a telephone on premises. LPA inspected the carbon monoxide detectors and it's near the kitchen and it's working well.