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 Licensee Renato Madrigal. There is three (3) ambulatory adults ages 18-59 and one (1) non-ambulatory adult over the age of 59. The facility is licensed as a level 3 home vendored by San Gabriel/Pomona Regional Center.

The following 12 (CARE) tool domains were observed and reviewed: Infection Control, Physical Plant/Environment Safety, Operational Requirements, Staffing, Personnel Records/Staff Training, Client Rights/Information, Client Records/Incident Reports, Food Service, Health Related Services, Incident Medical and Dental, Disaster Preparedness, and Emergency Intervention.

Infection control practices and Personal Protective Equipment (PPEs) were observed. The facility encourages hand washing and self symptom check of staff and visitors. Each resident bedroom is designated as a COVID-19 isolation room if needed. The facility has an Infection Control Plan and COVID-19 mitigation plan.

The facility is a single story home located in a residential neighborhood. It consists of 4 client bedrooms, 1 live-in staff room, 2 bathrooms, kitchen, dining room, living room, laundry area in attached garage, and outdoor shaded patio area. The facility has a fire pull-alarm system.

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. Smoke and carbon monoxide detectors are operational. The facility has two (2) fully charged fire extinguishers. Cleaning supplies and toxic substances are inaccessible to clients.

Water temperature readings measured between the required 105 - 120 degrees Fahrenheit.