Facility Evaluation Report

Licensing Program Analyst (LPA) Noemi Galarza made an unannounced annual inspection visit. The purpose of the visit was explained to DSP Lidia Small. Assistant Administrator Olayinka King arrived shortly after. The facility serves developmentally disabled residents under age 59. The facility is licensed as a level 4G Adult Residential Facility (ARF) vendored by San Gabriel/Pomona Regional Center. The facility is a single story home located in a residential neighborhood consisting of 3 bedrooms, 2 bathrooms, living room, family room, dining room, office room, laundry room, kitchen, outdoor covered patio, 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. A fire-pull alarm was observed. The facility has (2) fully charged fire extinguishers. Storage areas for cleaning solutions/toxins, knives, and hazardous items were inaccessible to clients. Hot water temperature readings did not measure between the required 105 - 120 degrees Fahrenheit; readings were 129.7- 129.9 DF. Resident (R2's) mattress had a metal spring sticking out in the lower part of the mattress.

Operational Requirements: Fire clearance is approved for four (4) ambulatory and (2) non-ambulatory 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. The Surety Bond expires 7/17/2025.

Staffing: A total of (9) staff members provide care and supervision to the clients.

Personnel Records/Staff Training: Six (6) staff files were reviewed. Criminal background clearance, in-service training, 1st Aid/CPR training, CPI/ Pro-Act training and health screening.

Administrator certificate expired 7/9/2024. Mr. Piggee provided proof that recertification training was submitted on 6/25/2023 and is currently pending.