Facility Evaluation Report

Licensing Program Analyst (LPA) Blanca Gonzalez conducted an unannounced required annual inspection. LPA was greeted by staff and the purpose of the visit was explained. Administrator Shorok Kharwish arrived shortly after.

The facility is licensed to serve six (6) elderly residents age 60 and above. All residents may be non-ambulatory. The facility is approved for a maximum of three (3) residents on hospice. The facility is a single-story home located in a residential area of San Dimas. The home consists of a kitchen, dining area, living room, (3) resident bedrooms, (2) bathrooms, an office space, staff room, laundry/storage space, and a backyard.

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

Doors, exits, hallways, and passageways were clear and free of obstruction. The front yard and back yards were observed to be clean and free of debris. There is an outdoor shaded seating area in a covered patio with sufficient seating for clients. No pools or bodies of water were observed in or around the home.

Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to residents, were observed to be inaccessible to residents. Carbon monoxide detector was observed by the front entry, tested and operational. Smoke detectors are located throughout the facility.