Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the unannounced annual inspection. LPA met with staff, Yossira Martinez, and explained the purpose of the visit. The facility is licensed for (4) adults, ages 18 - 59, of which (3) may be non-ambulatory. The home is vendorized by the San Gabriel/Pomona Regional Center.

LPA inspected the facility using the Compliance and Regulatory Enforcement (CARE) tools.

The single story facility consists of 4 client bedrooms, 2 bathrooms, living room, dining room, kitchen, and an attached garage. No swimming pool on the premises and no items obstructing the walkways. The backyard has a shaded area with table and chairs for clients use. Smoke and carbon monoxide combo detectors are operable throughout the home. LPA observed sufficient food supplies of perishable and nonperishable. Knives and cleaning solutions are locked and inaccessible to clients. The hot water temperature is measured within the required range of 105-120 degrees F. Staff are continuing to clean and disinfect throughout the day.

LPA reviewed (3) personnel files. Administrator's (Tammy Shindy) certificate expires on 9/25/27. Staff are fingerprint cleared and associated to the facility. Staff have current CPR & First Aid certificates and receiving annual training. LPA reviewed (3) client files and the P&I ledgers. Files are complete and clients are getting annual physicals and TB test. Medications are being administered as prescribed. The Emergency Disaster Plan is reviewed and updated as necessary. Disaster drills are being conducted, however, LPA issued a technical violation to ensure that the drills are being done as required.

No deficiencies issued today. An exit interview was held and a copy of this report was given to Staff Martinez.