Facility Evaluation Report

Licensing Program Analyst (LPA) Wong conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA met with DSP Dolores Ugaban and explained the reason of the visit. Later on, the facility administrator Rebecca Reichenberger arrived and assisted with the visit. The facility is approved for serve for six (6) ambulatory Developmentally Disabled Adults ages 18-59. The facility is licensed as a Level 2 home vendored by San Gabriel Pomona Regional Center.

The following twelve (12) tool domains were observed and reviewed: Infection Control, Physical Plant/Environmental Safety, Operational Requirements, Staffing, Personal Records-Training, Client Rights/Information, Client Records/Incident Reports, Food Service, Health Related Services, Incidental Medical Services, Disaster Preparedness and Emergency Intervention.

1. Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. The facility still encourages hand washing. The facility has an Infection Control Plan and COVID-19 mitigation plan in place.

2.Physical Plant and Environmental Safety: The facility is a single story house and located in a residential neighborhood area. The facility includes: living room, dining area, family room, kitchen, three clients bedrooms, one client bathroom and one live in staff bedroom and bathroom and an attached garage. Each clients' bedrooms has two beds, two chairs, two night stands, required furniture and beddings and sufficient lighting and closet space. The client bathroom is clean, sanitary and in a good working condition. The hot water temperature tested in a client bathroom was 118.7 which is within the Title 22 regulation.