Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the unannounced annual inspection. LPA met with the Administrator, Brian Sabillo, and explained the purpose of the visit. The facility is licensed for 4 ambulatory clients only. There are currently 3 clients residing at the home, and were placed by the San Gabriel/Pomona Regional Center.

The facility is a single story home consisting of 3 client bedrooms, 2 bathrooms, living room, dining area, kitchen, and an attached garage used as a staff office. The backyard has shaded area with tables and chairs. Each client bedroom has the required furniture such as a bed, a night stand, chair, and closet space. The facility has interconnected smoke detectors and a carbon monoxide detector in the bedroom hallway. The hot water temperature was measured within the required range of 105-120 degrees F. Knives and cleaning supplies are locked in a storage room. Food supplies are sufficient. LPA observed video surveillance in the common areas. LPA asked to submit an addendum to the plan of operation, admission agreement, and facility sketch.

LPA reviewed 3 personnel files. The administrator certificate expires on 12/1/26. Staff have current CPR & First Aid certificates. Staff are receiving annual training. LPA reviewed 3 client files. Client #2 and #3 are missing the TB test results. There is only one client taking medications, and meds are being administered as prescribed. Emergency Disaster Plan is updated and reviewed annually by the administrator. Drills are being conducted.

A deficiency was issued today. A copy of this report and appeal rights were given to the administrator.