Facility Evaluation Report

Licensing Program Analysts (LPA) Nune Margaryan conducted an annual required visit. LPA met with House Manager Estela Barrera and explained the reason for the visit. LPA used the infection control tool to evaluate the facility. The physical plant was inspected along with COVID-19 procedures, medications, food supply, and resident and staff records. The facility has an approved mitigation plan on file. The facility is licensed to serve developmentally disable clients between the ages 18 to 59. There are currently 4 clients residing at the home and receive services from San Gabriel / Pomona regional Center.

LPA toured the home and inspected dining room, living room, activity room, office, resident's bedrooms (4), resident's bathrooms (3 common bathrooms, 1 private located in the bedroom), laundry room, kitchen, attached garage and outside areas. The front and backyard are well maintained and there are no pools or large bodies of water. Passageways and exits are free of obstruction. There is a shaded seating area / patio for the clients. LPA observed fireplace in the living room which was secured with metal screen.

LPA observed laundry detergent, cleaning solutions/disinfectants are stored and locked in the laundry room. There is only one entrance being utilized at the facility, all required posters were posted at the entrance. There is a designated area in the living room where the log and PPE supplies are set up. LPA was screened upon entry. All staff were observed to be wearing mask upon entrance and during visit. Client bedrooms were checked. Each bedroom is equipped with the proper furnishings. The bathrooms were toured. Bathrooms are clean and have the required hygiene items. The hot water temperature was tested and was measured within Title 22 Regulation guidelines. The kitchen was inspected. There is sufficient perishable and non-perishable food. All the appliances are clean and working properly. Knives are locked in the kitchen cabinet under the sink and inaccessible to clients.