Facility Evaluation Report

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Required-1 year visit. LPA was met by Jacqueline Fuller, House Manager and explained the reason for the visit. Shortly after, Latonya King, Administrator arrived and assisted LPA. The facility is approved for (4) ambulatory developmentally disabled adults, age range 18-59, of which (1) may be non-ambulatory. The services are 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 maintained. Staff are adhering to infection control requirements. Infection Control Plan has been developed and included in the Plan of Operation.

Operational Requirements: A fire clearance is in place. Fire drill was last conducted on 07/06/2026 . The outdoor activity area provides a shaded area and furnished for outdoor use. Surety bond insurance in the amount of $3000 is in place and expires on 10/01/2026.

Physical Plant & Environment Safety: This facility is a single story home consists of (4) client bedrooms, (2) bathrooms, living room with covered fireplace, dining room, kitchen, and a garage. Client bedrooms were toured and each bedroom has a smoke detector, bed, linen, dresser, light, chair and sufficient closet space. Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. 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. There are cameras in the common areas. LPA observed broken window in C2's bedroom and the sliding door glass in the living room. Staff stated that C2 recently had a destructive behavior recently causing property destruction. C2 has been admitted to the hospital.

Staffing: A total of (13) staff members including the administrator provide care and supervision to the clients. Staff employed are over the age of 18 and have criminal background clearance, fingerprint cleared, have training and associated to the facility. Administrator certificate is valid and expires on 09/26/2026 . Administrator has a valid HIV/AIDs training, completed on 07/01/2026.