Facility Evaluation Report

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Required- 1 year visit. LPA met

with Loida Abcede, Asst. House Manager and explained the purpose of the visit. Shortly after, Alicia Federspiel, House Manager arrived to assist. The facility is licensed to care for (4) Developmentally Disabled Adults, ages 18 through 59, ambulatory only, (1) of which may be non-ambulatory. All clients residing at this 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 an approved Infection Control Plan. Staff are adhering to infection control requirements.

Physical Plant/Environment Safety: The facility is a single story home located in a residential

neighborhood, contains a total of (4) client bedrooms, (2) bathrooms, living room with covered fireplace, kitchen, dining area, breakfast nook, backyard, and attached garage. Currently, there are three (3) clients

living in the facility. The interior and exterior physical plant was inspected. Client bedrooms were toured. Each

bedroom has a smoke detector, bed, linen, dresser, light, chair and sufficient closet space. Exit doors are free of any obstruction and there are no pools or large bodies of water. Backyard was inspected and has a shaded area and sitting area. Laundry area is in the attached garage, which was inspected and there is an extra refrigerator/freezer to stock up additional food items. Kitchen knives, sharps objects, cleaning supplies and toxic substances are locked in a cabinet and inaccessible to clients. Smoke alarms and carbon monoxide were tested and operable. There are no firearms or weapons stored at the facility. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit.

Operational Requirements: LPA observed a fire extinguisher in the kitchen last serviced on 07/08/2026.

Facility has a surety bond insurance in the amount of $1000, valid until 04/01/2027. The facility provides a shaded and furnished outdoor activity area.