Facility Evaluation Report

Licensing Program Analysts (LPAs) Christine Wong and Daniel Konishi conducted the unannounced Annual Inspection and met with Administrator Rachel Sabillo who allowed the entry of the facility and explained the reason of today's visit and will be using the Compliance And Regulatory Enforcement (CARE) Tools to inspect the facility. The facility is licensed for age range 18 through 59 and ambulatory only. The facility is vendorized as Level 4G home with San Gabriel Pomona Regional Center.

The following domains were reviewed during today's annual required visit which included: infection control, physical plant and environmental, operational requirements, staffing, personnel 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 Plan: The facility staff would practice hand washing and using gloves when they have clients in the facility. Staff would clean and disinfect once a day and more often for high touched surfaces area. Facility has sufficient PPE supplies and has an Infection Control Plan in place

2. Physical Plant and Environmental Safety: The facility is a single story house and located in residential neighborhood area. The facility includes: living room, dining area, kitchen, three clients bedrooms, two clients bathrooms and staff office. Bedroom#1 has two beds, two chairs, two night stands, required beddings and furniture and sufficient lighting and closet space. Bedroom#2 and #3 has one bed, one chair, one night stand, one dresser, required furniture and bedding and sufficient lighting and closet space. The two clients bathrooms are clean, sanitary and in a good working condition. The hot water temperature in the client bathrooms are tested at 113 degrees F. which is within the Title 22 regulation. The appliances in the kitchen are working well. The sharp knives were locked in the box in the closet cabinet in the staff office. The cleaning supplies are stored and locked in a cabinet in the staff office. The extra personal hygiene products are stored in a cabinet near the entrance door. LPA inspected the smoke detectors and carbon monoxide detectors are working properly. The hallway night is always on during the night time for client to access the non-private bathrooms. The facility has a telephone service on the premises. The passageway, walkway and patio are free of obstruction.