Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the annual inspection on 5/14/24. LPA arrived unannounced and met with Staff, Julian Carmona. The purpose of the visit was explained. The facility is licensed for (4) ambulatory clients, ages 18 - 59. There are 4 ambulatory clients residing at the home. The facility is vendorized by the San Gabriel/Pomona Regional Center.

LPA utilized the CARE tool to inspect the facility and observed the following:

The single-story home consists of 3 client bedrooms, 2 bathrooms, living room, open kitchen and dining room, and attached garage. There is no swimming pool on the premises or any items obstructing the walkways. The backyard has a shaded away with a table and chair. Extra hygiene and linens are locked in the cabinet. There is a smoke detector in each of the rooms and a carbon monoxide detector in the hallway. Food supplies are sufficient. Knives and cleaning solutions are locked in the closet.

LPA reviewed all 4 client files and the required documents are found in their files. Medications are centrally locked in the hallway cabinet. The medications are being administered as prescribed by the physicians. LPA reviewed 4 personnel files. Staff files have the required documents such as health screening with TB results and CPR/First Aid certificates. Staff have fingerprint clearance and associated to the facility. Staff have sufficient training to provide care and supervision to clients. There are no clients utilizing postural supports or have any restricted or prohibited health conditions. The clients have internet access device to use. The facility has the updated Emergency Disaster Plan and is conducting quarterly disaster drills.

No deficiencies were issued today. An exit interview was held and a copy of this report was given to the administrator.