Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA arrived unannounced and met with Staff. The licensee, Kevin Van Beek, arrived shortly to assist with the visit. The facility is licensed for six (6) adults, ages 18 to 59, of which four (4) non-ambulatory. The home is vendorized by the San Gabriel/Pomona Regional Center.

The facility has 4 client bedrooms, 2 bathrooms, living room, dining room, family room, kitchen, and attached garage. Client bedrooms are equipped with the appropriate furniture and storage space. There are extra linens and hygiene supplies. Facility has operable smoke detectors that are interconnected and a carbon monoxide detector in the hallway. Knives and cleaning solutions are locked. The hot water temperature was measured between 105-120 degrees F. There are sufficient food supplies of 2 day perishable and a week of non-perishable items. The backyard has a shaded area with table and chairs. There are no items obstructing the walkways. The fireplace is secured with a cover. Staff are providing care and supervision to meet the clients' needs. Staff are fingerprint cleared and associated to the facility. LPA reviewed (3) staff files and files are complete. Administrator's (Michelle Plaza) certificate expires on 1/13/27 and the HIV & TB certificates are current. Staff have current CPR & First Aid certificates and receiving appropriate annual training. Staff do not use any manual restraints on clients. There are no clients with a restricted or prohibited health condition. LPA reviewed (6) client files and their medications. All files contain the required documents. Medications are being administered as prescribed. The facility has the updated emergency and disaster plan and is conducting monthly drills.

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