Senior Care Records.

Facility Evaluation Report

Delta Home Care II, West Covina12/03/2024Licence 198603587

Capacity4
Census4
Date signed12/03/2024 12:53:50 PM
The inspector’s account

Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year visit. The purpose of the visit was explained to staff Ricardo Evangelista. Assistant Administrator Danielle Maximo arrived shortly after. The facility is licensed as an RCFE (Residential Care For the Elderly) for four (4) non-ambulatory developmentally disabled adults ages 60 and over. The facility is licensed as a level 4C RCFE vendored by San Gabriel/Pomona Regional Center. The following 12 Care Compliance and Regulatory Enforcement (CARE) tool domains were utilized during the inspection.

Infection Control: The Infection Control Plan was reviewed. The facility has a supply of Personal Protective Equipment (PPEs).

Operational Requirements: A fire clearance for 4 non-ambulatory residents ages 60 and over was approved on 6/2/2022. Facility handles resident P & I monies and has a current Surety Bond that expires 4/22/2026.

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. The facility has one (1) fully charged fire extinguisher and a fire pull alarm in the living room. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. The facility has a 1st Aid Kit and Manual. Cleaning supplies, knives, and toxic substances were observed locked and inaccessible to residents.

Staffing: A total of 8 staff members provide care and supervision to the clients.

Personnel Records/Staff Training: Administrator certificate expired 7/10/2024. Proof of pending approval from CCL Recertification Unit was provided. Staff have criminal background clearance and training. Five (5) staff files were reviewed. Proof of staff training, health and TB clearance, and 1st Aid/CPR training are on file. Proof of in-service training that includes HCBS Final rule was observed in staff files.

****Report narrative continues next page.*****

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction