Facility Evaluation Report

Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year visit focusing on COVID-19 Infection Control Practices. LPA met with DSP staff Karla Williams and explained the purpose of the visit. LPA spoke to Administrator Kevin Piggee telephonically. There are four (4) level 4G developmentally disabled clients ages 18-59. The facility is serviced by San Gabriel/Pomona Regional Center. The facility is a single story home located in a residential neighborhood that is licensed for 4 ambulatory and 2 non-ambulatory clients. It consists of 3 bedrooms, 2 bathrooms, living room, family room, dining room, office room, laundry room, kitchen, outdoor covered patio, and attached garage.

COVID-19 Infection Control signs were observed in the entrance, common areas, hallways, and bathrooms. Signs are posted throughout the facility to promote hand washing, cough/sneeze etiquette, and physical distancing. A visitor screening station is in the entry. It includes a thermometer, hand sanitizer, masks, and gloves. is in place. Personal Protective Equipment (PPE's) was observed.

Two (2) residents are being isolated due to cold and/or flu-like symptoms. They will be tested for COVID-19 today. Due to developmental cognitive impairment the residents were not observed wearing face masks for infection protection. Staff was observed wearing a face mask.

The office room has been designated as a COVID-19 isolation room if needed.

One (1) month supply of centrally stored medications were observed.

Sufficient supply of perishable for 2 days & non-perishable foods for 7 days were observed.

A posted Emergency Disaster Plan was observed. Criminal Background Clearance was checked.

The last fire drill was conducted on 9/13/2022.

Administrator Certificate expires 7/9/2024.

Exit interview was conducted with DSP Karla Williams. A copy of the report was issued.