Facility Evaluation Report

Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA explained the purpose of the visit to staff Keith Morgan. Administrator Jason Piggee was explained the purpose of the visit telephonically. There are four (4) ambulatory developmentally disabled adults ages 18-59. The facility is licensed as a level 4i home vendored by San Gabriel/Pomona Regional Center. Twelve (12) Adult CARE tool domains were observed and reviewed.

Infection control practices and Personal Protective Equipment (PPEs) were observed. The facility encourages hand washing and self symptom check of staff and visitors. The facility has an Infection Control Plan and COVID-19 mitigation plan.

The facility is a single story home located in a residential neighborhood. It consists of 3 client bedrooms, 2 bathrooms, dining room/family room, kitchen, living room, outdoor patio, and detached garage.

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. Cleaning supplies were observed unlocked in bedroom # 3. Staff immediately removed them and locked them. Citation was issued.

Bedroom #2's wall has a hole and walls are dirty.

Water temperature readings measured between the required 105 - 120 degrees Fahrenheit.