Facility Evaluation Report

Licensing Program Analyst (LPA) Alberto Lopez conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA met with Tara Martinez and 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.

Facility is licensed to served 5 adults between the ages of 18-59 years old. Currently there are 2 clients over 60 years of age.

1. Infection Control : Infection control practices and Personal Protective Equipment (PPEs) were observed. Facility is disinfecting throughout the day.

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 have 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 nightstands, 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 116.4 and 119.8 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).