Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the required annual inspection. LPA arrived unannounced and met with Administrator, Stephanie Baynosa. The purpose for 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.

LPA used the Compliance and Regulatory Enforcement (CARE) tools to inspect the facility today.

The facility consists of 4 client bedrooms, 2 bathrooms, living room, dining room, kitchen, and attached garage. There is a spacious backyard with a shaded area. No pool on the premises. There are currently 4 clients (3 ambulatory and 1 non-ambulatory) residing at the home. There is sufficient staffing to provide care and supervision. Facility has one awake staff in the overnight shift. 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. Knives and medications are locked in the same cabinet. There are sufficient food supplies of 2 day perishable and a week of non-perishable items.

LPA reviewed records for 3 staff and 4 client files. The administrator's certificate expires 12/10/26 and the HIV & TB certificate was issued on 11/1/24. Staff have current CPR & First Aid certificates. Staff are receiving on-going training throughout the year. Client files have the required documents. Medications are being given as prescribed by the physician. The Emergency Disaster Plan is being reviewed annually and facility is conducting monthly disaster drills.

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