Facility Evaluation Report

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Required- 1 year visit. LPA was met by Eduardo Zamora, RBT/Lead staff and explained the purpose of the visit. The facility is licensed to care for (4) Developmentally Disabled Adults, ages 18 through 59, (4) non ambulatory, approved for delayed egress on exterior gates only. All clients residing at this facility receive case management services provided by San Gabriel Pomona Regional Center. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. Bathrooms have hand soap, toilet paper, wipes and paper towels. Staff are adhering to infection control requirements. Staff are trained in the proper use of all required PPEs. The Emergency Infection Control Plan includes the required applicable infection control measures.

Physical Plant/Environment Safety: The facility is a single story home located in a residential neighborhood, contains a total of (4) client bedrooms, (3) bathrooms, a living room, recreation/activity room, kitchen, dining area, backyard, and laundry area in the attached garage. Currently, there are (4) clients living in the facility. The interior and exterior physical plant was inspected. Client bedrooms were toured. Each bedroom has a bed, linen, dresser, light, chair and sufficient closet space. Bathrooms have liquid soap and toilet paper. Exit doors are free of any obstruction and there are no pools or large bodies of water. Backyard was inspected and has a shaded area and sitting area. Attached garage was inspected and LPA observed the laundry area and exercise equipment inside. Kitchen knives, sharps objects are locked and inaccessible to clients. There are (2) fire extinguishers observed to be fully charged and were last serviced on 11/07/2025. Smoke alarms and carbon monoxide are interconnected. There are no firearms or weapons stored at the facility. Hot water temperature readings measured within the required 105 - 120 degrees Fahrenheit. Hot water supply measured at 106.5 deg F in bathroom #1, and 108.3 deg F in bathroom #2.

Operational Requirements: A fire clearance is in place. Surety Bond is valid in the amount of $3500 and expires on 06/20/2027. Fire alarm and carbon mono xide system is tested. Fire drill is conducted monthly, last earthquake/fire drill was conducted on 01/05/2026. The outdoor activity area is furnished, comfortable and has shade.