Facility Evaluation Report

Licensing Program Analysts (LPAs) Nune Margaryan and Mayra Cota conducted an unannounced annual visit. LPAs met with staff Corazon Bondoc who assisted with the visit. Administrator Olivia Tomines arrived shortly after. LPAs explained the reason for the visit. LPAs used the infection control tool to evaluate the facility. The physical plant was inspected along with medications, food supply, and clients and staff records. Facility submitted infection control plan to CDSS. 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. Three (3) clients were at the Day program at the time of visit.

The facility is located in a residential area. LPAs toured the home and inspected living room, dining room / den, kitchen, 4 bedrooms, 2 bathrooms and the garage. Laundry area was observed in the garage. LPAs observed laundry detergent are stored in the garage and garage door was not locked. The front and backyard are well maintained and there are no pools or large bodies of water. LPAs observed a wood canopy in the backyard for the clients but without tarp cover. Passageways and exits are free of obstruction. There is a activity supplies caddy in the corner of den. LPAs observed the metal hammer in the supplies caddy. There is only one entrance being utilized at the facility, all required posters were posted at the entrance. Client bedrooms were checked. Each bedroom is equipped with the proper furnishings. Bedrooms also have sufficient closet space. 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. Sharps are locked and are inaccessible to clients.