Facility Evaluation Report

Licensing Program Analyst (LPA) Wong conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA met with Roger Escorcia and explained the reason of the visit. The facility is approved for serve Developmentally Disabled Adults, five (5) ambulatory clients. The facility is licensed as a 4F home vendored by San Gabriel Pomona Regional Center.

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

1. Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. The facility still encourages hand washing, still checking client temperature twice a day and staff disinfected the facility every shift. The facility has an Infection Control Plan and COVID-19 mitigation plan in place.

2. Physical Environmental and Safety: The facility is a single story house and located on a busy street but residential neighborhood area. The facility includes living room #1, living room#2, kitchen, dining area, den/staff office/client's activity room, three clients bedrooms and two bathrooms, laundry room and a detached garage. Bedroom#1 and #3 has one bed, one drawer, one night stand, one chair, required furniture and bedding and sufficient lighting and closet space. Bedroom#2 has two beds, two chairs, two night stands, two drawers, required furniture and beddings and sufficient lighting and closet space. The two client bathrooms are clean, sanitary and in a good working condition. The two bathrooms hot water were tested between 108.5 and 111.10 degrees F which are within the Title 22 regulation. The appliances in the living room and kitchen are working well. The knives and sharp utensils are stored and locked in the kitchen cabinet (Medication Cabinet).