Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the required annual inspection on 7/15/25. LPA arrived unannounced and met with Staff, Emily Chhun. The reason for the visit was explained. The administrator, Evelina Schaefer, arrived shortly after. The facility is licensed for (6) adults, ages 18 - 59, ambulatory only. The facility is vendorized by the San Gabriel/Pomona Regional Center.

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

The facility consists of 4 client bedrooms, 1 Staff room, 2 bathrooms, dining room, staff/client activity area, kitchen, and an attached garage. Client bedrooms have the appropriate furniture and storage space. There are extra linens and hygiene supplies. Sufficient food supplies of 2 day perishable and a week of non-perishable items are observed. Facility has smoke and carbon monoxide combo detector in each room. 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. Staff are continuing to follow their infection control plan and procedures. Per the administrator, there is sufficient staffing to assist the clients and an awake staff for the overnight shift. Staff are all fingerprint cleared and associated to the facility. LPA reviewed records for 3 staff and 6 Clients. Administrator's (Evelina Schaefer) certificate expires on 10/19/25 and the HIV & TB certificate was issued on 5/21/25. Facility staff have current CPR & First Aid certificates. Staff do not use any manual restraints on clients. Medications are centrally locked and inaccessible to clients. LPA reviewed medications for all 6 clients and are being administered as prescribed. The client files have all the required documents. The emergency and disaster plan is reviewed annually and facility is conducting disaster drills at least quarterly.

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