Facility Evaluation Report
Licensing Program Analyst (LPA) Cynthia Chan conducted the required annual inspection on 4/30/24. LPA arrived unannounced and met with Staff, Leo Siongco. The purpose of the visit was explained. The facility is licensed for (4) adults, ages 18 - 59, of which 1 may be non-ambulatory in bedroom #3. The facility is vendorized by the San Gabriel/Pomona Regional Center at a level 4G home.
LPA utilized the Compliance and Regulatory Enforcement (CARE) tool to inspect the facility. The following were observed:
The facility has 4 private client bedrooms, 2 bathrooms, living room, dining area, kitchen, attached garage, a spacious backyard with shaded area. There are no pools or bodies of water on the premises. There are currently 4 clients (3 ambulatory and 1 non-ambulatory) residing at the home. Staff are providing care and supervision to meet the clients' needs and assisting in activities of daily living. There is one awake staff in the overnight shift to supervisor clients. The facility staff are continuing to use appropriate hand hygiene and wearing gloves while assisting clients. Cleaning supplies are locked in the garage storage cabinet. There are sufficient food supplies of 2 day perishable and a week of non-perishable items. Foods are properly stored in the refrigerator and labeled when opened.
LPA reviewed records for 4 staff and 4 client files. They have the required documents in their files. Staff have current CPR & First Aid certificates. Staff are receiving on-going training throughout the year. The administrator's certificate expires on 12/10/24. Client files have the required documents. There is one client with a restricted health condition and the restricted health plan is placed in the file. Medications are centrally stored and locked in a cabinet. The medications are being administered as prescribed. There are no clients requiring postural supports at the home. Facility conducts monthly disaster drills.
No deficiency issued today. An exit interview was held and a copy of this report was given to Staff Siongco.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction