Facility Evaluation Report

Licensing Program Analyst (LPA) Noemi Galarza made an unannounced Required - 1 year annual inspection visit. The purpose of the visit was explained telephonically to Administrator Myrabel Vitangcol. DSP Milagros Francisco assisted with the visit. The facility serves developmentally disabled residents under age 59. The facility is licensed as a level 4C Adult Residential Facility (ARF) vendored by San Gabriel/Pomona Regional Center. The facility is a single story home located in a residential neighborhood that is licensed for 4 ambulatory only clients. It consists of 4 resident bedrooms, office room, living room, dining room, kitchen, 2 bathrooms, backyard patio area, and attached garage. The following 12 (CARE) tool domains were utilized during the inspection.

Infection Control: The facility has an Infection Control Plan in place.

Physical Plant/Environment Safety: The interior and exterior physical plant was inspected. Exit doors are free of any obstruction and there are no pools or large bodies of water. Smoke and carbon monoxide detectors were tested and are operational. The facility has one (1) fully charged fire extinguisher. Hot water temperature readings measured between the required 105 - 120 degrees Fahrenheit. Storage areas for cleaning solutions/toxins, knives, and hazardous items were inaccessible to clients.

Operational Requirements: Fire clearance is approved for four (4) ambulatory only residents. Care and supervision to meet the clients needs was observed. No special equipment and supplies are used by clients. Facility manages residents P & I monies. Facility has a Surety Bond.

Staffing: A total of seven (7) staff members provide care and supervision to the clients.

Personnel Records/Staff Training: Five (5) staff files were reviewed. Criminal background clearance, in-service training, CPI training, 1st Aid/CPR training, and health screening.

Administrator certificate expired 8/27/2024. Administrator provided proof that recertification application was submitted to DSS Certification Unit, and is presently pending processing.