Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the required annual inspection. LPA arrived unannounced and met with staff The reason for the visit was explained. Administrator, Anthony Ngo, arrived shortly thereafter to assist with the visit. The facility is licensed for (6) adults, ages 18 - 59, of which 2 may be non-ambulatory. Bedroom #2 is approved for non-ambulatory. The facility is vendorized by the San Gabriel/Pomona Regional Center. There are 4 clients currently residing at the home.

LPA inspected the facility using the Compliance and Regulatory Enforcement (CARE) tools.

The facility consists of 3 client bedrooms, 2 staff rooms, living room, dining room, kitchen, and attached garage. The bedrooms have appropriate furniture and storage space. There are extra linens and hygiene supplies. Facility has smoke detectors in each room and a carbon monoxide detector located in the dining area. Knives, cleaning solutions, and disinfectants are locked. The hot water temperature was measured between the required range of 105-120 degrees F. Staff are providing care and supervision to meet the clients' needs and assisting in activities of daily living. Staff are continuing to follow their infection control plan and procedures while handling clients. Sufficient food supplies of 2 day perishable and a week of non-perishable items observed. LPA reviewed records and medications for 4 clients. The clients files have the required documents and medications are being administered as prescribed. Medications are centrally locked. LPA also reviewed 3 personnel records. Administrator (Anthony Ngo) certificate expires on 11/3/27 and HIV & TB was issued on 5/29/25. Facility staff have current CPR & First Aid certificates. The facility has the updated emergency disaster plan and is conducting drills quarterly.

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