Facility Evaluation Report

Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA explained the purpose of the visit to Administrator Lilibeth Esguerra-Nuckolls. There are four (4) ambulatory developmentally disabled adults. Two (2) residents are over the age of 59, and two (2) are under age 59. The facility is licensed as a level 4A home vendored by San Gabriel/Pomona Regional Center. Twelve (12) Adult CARE tool domains were observed and reviewed.

Infection control practices and Personal Protective Equipment (PPEs) were observed. Infection Control Plan and COVID-19 Mitigation Plan, and Monkey Pox Plan were reviewed.

The facility is a single story home located in a residential neighborhood. It consists of 4 resident bedrooms, 1 office room, 2 bathrooms, kitchen, dining room, living room, outdoor patio, and a detached garage with laundry area.

The interior and exterior physical plant was inspected. Exit doors are free of any obstruction and there are no pools or large bodies of water. Smoke and carbon monoxide detectors were tested and are operational. The facility has one (1) fully charged fire extinguisher.

Water temperature readings measured between the required 105 - 120 degrees Fahrenheit.

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