Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the unannounced annual inspection on 8/7/25. LPA met with Administrator, Kevin Van Beek, 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 in rooms #3. The facility is vendorized by the San Gabriel/Pomona Regional Center. There are four (4) clients residing at the home.

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, kitchen, and detached garage. No swimming pool or items obstructing the walkways. 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. Facility has operable smoke and carbon monoxide detectors throughout the home and are interconnected.

LPA reviewed medications for all clients. Medications are centrally stored and locked in the living room area. Staff are administering the medications as prescribed. LPA reviewed 3 staff files and 4 client files. The administrator's certificate (Kevin Van Beek) expires on 9/18/26 and and administrator has the current HIV and TB certificates. Staff have current CPR & First Aid training and are receiving on-going training. Client files are complete and none of the clients has a restricted health condition. 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.