Facility Evaluation Report

Licensing Program Analyst (LPA) Alberto Lopez conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA met with DSP David Alekhuogie who allowed the entry of the facility and LPA explained the purpose of the visit. Shortly after, Assistant Administrator Latonya King arrived and assisted LPA with the visit. The facility is approved for serve Developmentally Disabled Adults age range 18 to 59. 4 non-ambulatory and approved for Delayed Egress. The facility is vendorized as Level 4 Home with San Gabriel Pomona Regional Center.

The following twelve (3) tool domains were observed and reviewed: Infection Control, Physical Plant/Environmental Safety, and Food Service.

Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. The facility still encourages hand washing. The facility has an Infection Control Plan and COVID-19 mitigation plan in place.

2. Physical Plant and Environmental Safety: The facility is a single-story house and located in a residential neighborhood area. The facility includes living room, family room, dining area, kitchen, staff/visitor bathroom, two clients bathrooms, four clients bedrooms, administrator office, laundry room and a detached garage. All four clients bedrooms have one bed, one chair, one night stand, required beddings and furniture, sufficient lighting and closet space. All clients bathrooms are clean, sanitary and in a good working condition. The hot water temperature in both clients bathrooms were tested between 111.0 and 118.9 degrees F which is within the Title 22 regulation. All the kitchen appliances are working properly. The sharp knives and utensils are stored locked in the administrator office. The cleaning supplies are stored and locked in the storage room near the kitchen.