Senior Care Records.

Facility Evaluation Report

David Adult Residential Home, Walnut05/18/2022Licence 198603350

Capacity4
Census3
Date signed05/18/2022 11:17:22 AM
The inspector’s account

Licensing Program Analyst's (LPA's) Vasallo conducted an annual required visit. LPA met with staff member, Andre Simon and explained the reason for the visit. Administrator, Arlisha York was notified via phone of the visit. LPA used the infection control tool to evaluate the facility. LPA observed the physical plant, COVID-19 procedures, reviewed clients' medications and records and observed the food supply, The facility cares for adults with developmental disabilities and is vendorized by San Gabriel/Pomona Regional Center as a Level 4I facility.

All client bedrooms were toured. Each bedroom has a bed, linen, dresser, light, and sufficient closet space. Both client bathrooms were toured and the hot water was 118.2 degrees which is within the required 105 - 120 degrees. There were no toxic chemicals accessible to clients. The kitchen was inspected. There is sufficient perishable and non-perishable food. All the appliances are clean and seem to be operating properly. The common areas include the living room and dining area. These areas are clean and have the required furniture. There is a screening station at the entrance of the home which has PPEs and a thermometer to screen visitors. Staff document client temperatures daily and require visitors to sign in. Facility currently has at least a 30-day supply of PPEs. There are cameras inside and outside the home only in common areas.

Client files were reviewed to confirm emergency contacts are updated. Staff files were reviewed to confirm health screenings, training and fingerprint clearances. All clients' medications were reviewed. Medications are documented properly and given as prescribed.

Per California Code of Regulations, Title 22, there were no deficiencies observed during the visit. Exit interview held. A copy of the report was provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction