Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the annual inspection with the focus of the infection control domain. LPA was allowed entry by Staff, John Beltran, and the purpose of the visit was explained. The facility is licensed for 6 developmentally disabled adults, ages 18 to 59, and of which 4 may be non-ambulatory. There are currently 5 clients residing in the home and receive services from the San Gabriel/Pomona Regional Center.

LPA toured the facility and observed the following:

* There are 5 bedrooms (3 for clients and 2 for live-in staff), 2 bathrooms, living room, dining room, family room, kitchen, and an attached garage. The laundry room is located in the back yard area.

* Covid-19 signage are posted throughout the home. Hand washing signs are posted in the bathrooms.

* PPE station is set up by the front door. Extra PPE supplies are stored in the shed.

* The facility documents temperature of visitors, staff, and clients.

* Food supplies of 2 day perishable and a week of non-perishable are observed.

* The smoke detectors and a carbon monoxide detector are operable.

* Medications are centrally stored and locked in the kitchen cabinet. LPA reviewed all 5 clients' medications and the medications are being administered as prescribed.

* All 5 client files have updated emergency information. The emergency contact information for other agencies are posted for staff.

* Interviews were conducted with the 3 Staff.

* Staff stated they clean at least once a day. Cleaning solutions are stored in the laundry room. During the tour, LPA observed the laundry room open and cabinets with chemicals were unlocked, making them accessible to clients.

A deficiency was cited on the LIC809D page. An exit interview was held. A copy of this report along with appeal rights were given to Staff Rolando Manalad.