Facility Evaluation Report

Licensing Program Analyst (LPA) Noemi Galarza made an unannounced annual inspection visit. The purpose of the visit was explained to DSP Thamia Giles. The facility serves developmentally disabled residents under age 59. The facility is licensed as a level 4I Adult Residential Facility (ARF) vendored by San Gabriel/Pomona Regional Center. The facility is a single story home licensed for 4 ambulatory residents. It is located in a residential area consisting of 3 client bedrooms, dining room, kitchen, living room, family room, 2 bathrooms, backyard with shaded patio furniture, and detached 2-car garage. The facility has a fire pull-alarm. The following 12 (CARE) tool domains were utilized during the inspection.

Infection Control: The facility staff are using appropriate hand hygiene cleaning and disinfecting the home. An Infection Control Plan was reviewed.

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. The facility has one (1) fully charged fire extinguisher. Hot water temperature readings measured between the required 105 - 120 degrees Fahrenheit. Storage areas for cleaning solutions/toxins, knives, and hazardous items were inaccessible to clients.

Operational Requirements: Fire clearance is approved for four (4) ambulatory only 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 7/1/2025.

Staffing: A total of eight (8) 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, and health screening. Staff (S5 & S6) have expired Pro-Act training.

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