Facility Evaluation Report

Licensing Program Analyst (LPA) Noemi Galarza made an unannounced annual inspection visit. The purpose of the visit was explained to Victor Taclob. Licensee Renato Madrigal arrived shortly after. The facility serves developmentally disabled residents under age 59, and is licensed as a level 3 Adult Residential Facility (ARF) vendored by San Gabriel/Pomona Regional Center. The facility is a single story home located in a residential neighborhood. It consists of 4 resident 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 following 12 (CARE) tool domains were utilized during the inspection.

Infection Control: The facility staff are using appropriate hand hygiene cleaning and disinfecting the home. An Infection Control Plan was reviewed.

Physical Plant/Environment Safety: 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 were tested and are operational. The facility has one (1) fully charged fire extinguisher. Hot water temperature readings measured between the required 105 - 120 degrees Fahrenheit. Storage areas for cleaning solutions/toxins were locked.

A kitchen drawer had a knife and pair of scissors that were unlocked, accessible to residents in care. Staff immediately locked the items in the regular sharps storage area.

Operational Requirements: Fire clearance is approved for four (4) ambulatory only residents. Care and supervision to meet the clients needs was observed. No special equipment and supplies are used by clients. Facility manages residents P & I monies. The Surety Bond expires 5/16/2024.

Staffing: A total of four (4) staff members provide care and supervision to the clients.