Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Wong conducted the required annual inspection. LPA arrived unannounced and met with DSP Amberly Huynh and Briana Rodriguez who allowed the entry of the facility and explained the reason of the visit and Shortly after, the administrator Kevin Van Beek arrive and assisted with the visit. The facility is licensed for age range 18 through 59. Two (2) ambulatory and four (4) non-ambulatory. The facility is a Level 4G home vendored by San Gabriel Pomona Regional Center.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and following were observed:

1. Infection Control: The facility staff are using appropriate hand hygiene and wearing gloves while assisting clients. Staff are cleaning and disinfecting at least once a day and more often for high touched surfaces. Facility has sufficient PPE supplies and has an Infection Control Plan in place.

2, Physical Plant: The facility is a single story house and located at a residential neighborhood area. The facility includes: kitchen, dining area, living room, family room, four clients bedrooms, two bathrooms and attached garage. Bedroom#1 and #2 has two beds, chairs, drawers, required furniture and bedding and sufficient lighting and closet space. Bedroom#3 and #4 has one bed, one chair, one night stand, one drawer, required furniture and bedding and sufficient closet space and lighting. The two clients bathrooms are clean, sanitary and in a good working condition. The hot water in two bathrooms were tested between 111.7 and 112.3 degrees F which are within the Title 22 regulation. The appliances in the kitchen and living room are all a working well. All the sharp knives are stored and locked in the kitchen cabinet. The chemicals and all cleaning supplies are stored in the locked cabinet in the garage. The extra personal hygiene products are stored in the locked cabinet in the garage. The extra linen are stored in the hallway cabinet. LPA inspected the carbon monoxide detector and smoke detectors and they are all working well.