Facility Evaluation Report

Licensing Program Analyst (LPA) Daniel Konishi conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA was met by Hector Vargas, Administrator and explained the purpose of the visit. Facility is licensed for 40 residents age range 60 and over, of which 30 ambulatory and 10 non-ambulatory; approved hospice waiver for (5) hospice residents. There are currently (34) residents, 60 years and older residing in the facility, (0) bedridden and (0) hospice residents. Residents residing in the facility receive case management services provided by San Gabriel Pomona Regional Center.

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

Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. The facility has a updated Infection Control Plan in place. Staff are trained on the emergency infection control plan and following hand hygiene techniques. Emergency and disaster plan was completed and up to date.

Operational Requirements: A current Plan of Operation was reviewed. The Infection Control Plan has been added to the Plan. Facility does not accept or retain residents with dementia. LPA reviewed the Liability Insurance that is in place. LPA reviewed the Surety bond that is in place. Fire and Earthquake drill was last conducted on 07/09/2025.

Physical Plant/Environment Safety: The facility is a single-story building located in a commercial area. The facility consists of (2) separate buildings: the 1st building (single story) consists of (20) resident rooms and (14) bathrooms, (5) community shower rooms. Outside patio, Medication room, Laundry room, Living room, Dining area, Kitchen and Pantry.