Facility Evaluation Report

Licensing Program Analyst (LPA) Galarza conducted an unannounced annual inspection visit. The purpose of the visit was explained to DSP Alma Lor. Assistant Administrator Danielle Maximo arrived shortly after. The facility serves elderly residents ages 60 and older whom are developmentally disabled. The facility is licensed as a level 4 RCFE vendored by San Gabriel/Pomona Regional Center.

Infection Control: The Infection Control Plan was reviewed and includes environmental cleaning and disinfection activities. Facility has sufficient Personal Protective Equipment.

Operational Requirements: A hospice waiver for 4 residents is approved. A fire clearance was granted for 4 non-ambulatory residents, of which 1 may be bedridden. Liability Insurance in the amount of at least ($1,000,000) per occurrence and ($3,000,000) in total annual aggregate is current with an expiration date of 6/20/2026. Facility handles resident P & I monies. The Surety bond expires 2/8/2028.

Physical Plant/Environment Safety: The facility is a single story home located in a residential neighborhood consisting of 4 private resident bedrooms, 2 bathrooms, office, living room, dining room/kitchen, outdoor patio area with patio furniture, and 2 car detached garage with laundry area. 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 1st Aid Kit and Manual. Smoke and carbon monoxide detectors were tested and are operational. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. Cleaning supplies, knives, and toxic substances were observed unlocked/accessible to residents above the washer/laundry area. The last Emergency Disaster drill was conducted on 10/4/2025.

Resident (R1's) medical bed has full bed rails, but is not receiving hospice care. A citation was issued.

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