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 DSP staff Jeffrey Sandejas. Administrator Rosamaria Maximo arrived shortly after. There are four (4) level 4C developmentally disabled adults; of which one is under age 59. The facility is vendored by San Gabriel/Pomona Regional Center.

Infection control practices and Personal Protective Equipment (PPEs) were observed. There is a visitor sign-in station located in the main entrance. The facility has a COVID-19 Mitigation Plan and Infection Control Plan.

The facility has a Dementia Waiver in place. A Hospice Waiver for 4 is approved.

A fire clearance for 4 non-ambulatory adults 60 and over; of which one (1) may be bedridden in room #1.

Liability Insurance in the amount of at least ($1,000,000) per occurrence and ($3,000,000) in total annual aggregate is in place and expires 6/20/2024.

Facility handles resident's money. A Surety Bond in the amount of $2,000 is in place.