Facility Evaluation Report

Licensing Program Analyst (LPA) Wong conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA met Administrator Josefina Teodoro and explained the reason of the visit and the administrator also assisted with the visit. The facility is approved for serve Developmentally Disabled Adults 18-59 years old only and ambulatory only. The facility is licensed as a level 2 vendored by San Gabriel Pomona Regional Center.

The following twelve (12) tool domains were observed and reviewed: Infection Control, Physical Plant/Environmental Safety, Operational Requirements, Staffing, Personal Records-Training, Client Rights/Information, Client Records/Incident Reports, Food Service, Health Related Services, Incidental Medical Services, Disaster Preparedness and Emergency Intervention.

1. Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. The facility still encourages hand washing. The facility has an Infection Control Plan and COVID-19 mitigation plan in place.

2. Physical Plant and Environmental Safety: The facility is a single story house and located in a residential neighborhood area. The facility includes: living room, kitchen, dining area, family room, administrator bedroom, three clients bedrooms and one client bathroom. 1st and 3rd bedroom has two beds, two drawers, night stand, required furniture and beddings, sufficient lighting and closet space. 2nd bedroom has one bed, one night stand, one chair, drawer, required bedding and furniture and sufficient lighting and closet space. The client bathroom is clean, sanitary and in a good working condition. The hot water temperature in the client bathroom was tested at 125.7 degrees F which is over the Title 22 regulation. LPA inspected the carbon monoxide detectors and smoke detectors and they are all working probably. The walkway, passageway and the patio are free of obstruction.