Facility Evaluation Report

Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year visit. The purpose of the visit was explained to DSP Aldrin Demerin. Administrator Renato Madrigal was contacted telephonically and explained the purpose of the visit. The facility is licensed as a level 3 Adult Residential Facility (ARF) vendored by San Gabriel/Pomona Regional Center.

Infection Control: The Infection Control Plan includes Environmental cleaning and disinfection activities. Facility Personal Protective Equipment. Sufficient infection control supplies were observed.

Physical Plant/Environment Safety: 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. All client bedrooms had the required furniture for comfort and safety and had sufficient lighting. All outdoor passages were free of obstruction. Bathrooms were clean, toilets and water faucets worked properly. Water temperature was measured. Client bath towels, toiletries and personal hygiene supplies were adequately available. All storage areas for cleaning solutions, toxins, knives, and hazardous items are in locked cabinets. Smoke detectors and carbon monoxide detectors are operable and in compliance. There is one fire extinguisher and fire pull alarm. The facility has a 1st Aid Kit and Manual. The backyard is under construction with artificial turf.

The kitchen sink and 2 bathrooms hot water temperature measured above 105 -120 DF, [128.3 and 126.8].

Operational Requirements: Fire clearance is approved for four (4) non-ambulatory residents. Care and supervision to meet the clients needs was observed. One resident uses special equipment to ambulate. Facility manages residents P & I monies. The Surety Bond expires 5/16/2026.