Facility Evaluation Report

Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year visit. The purpose of the visit was explained to DSP Lidia Small. Administrator Olayinka King arrived later.The facility is licensed as a level 5 Adult Residential Facility (ARF) that serves developmentally disabled residents ages 59 and under vendored by San Gabriel/Pomona Regional Center. Administrator certificate expires 9/24/2026.

Infection Control: The facility has an Infection Control Plan that is reviewed annually.

Physical Plant/Environment Safety: The facility is a single story home located in a residential neighborhood. There are 3 bedrooms, 1 office, family room, dining room, living room, laundry room, kitchen, outdoor patio area with shade, and an attached garage. Cleaning supplies, knives, and toxic substances are inaccessible to residents. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. The facility has a 1st Aid Kit and manual. Smoke and carbon monoxide detectors were tested and are operational. The facility has three (3) fire extinguishers and a fire pull alarm. Exit doors are free of any obstruction and there are no pools or large bodies of water.

Operational Requirements: Fire clearance is approved for 2 non-ambulatory and 4 ambulatory residents.

Currently all residents are ambulatory. Care and supervision to meet the clients needs was observed. The use of special equipment and supplies is used for a resident. The Surety Bond expires 7/14/2027. he facility has liability insurance in place.

Staffing: A total of 11 staff members provide care and supervision to the clients.