Facility Evaluation Report

Licensing Program Analyst ( LPA) Galarza conducted an unannounced Required- 1 year visit. The purpose of the visit was explained to staff Jorielle Asprec . Administrator Lilibeth Esguerra arrived shortly after. The facility is licensed for 4 developmentally disabled residents ages 59 and under. The facility is licensed as a level 4A RCFE vendored by San Gabriel/Pomona Regional Center. The fo llowing 12 Care Compliance and Regulatory Enforcement (CARE) tool domains were utilized during the inspection.

Infection Control: The Infection Control Plan was reviewed. The facility has a supply of Personal Protective Equipment (PPEs).

Operational Requirements: A fire clearance for 4 non-ambulatory residents ages 59 and under was approved on 11/30/22. Facility handles resident P & I monies and has a current Surety Bond that expires 4/26/2025.

Physical Plant/Environment Safety: 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. The facility has one (1) fully charged fire extinguisher and a fire pull alarm in the living room. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. The facility has a 1st Aid Kit and Manual. Cleaning supplies, knives, and toxic substances were observed locked and inaccessible to residents.

Staffing: A total of 6 staff members provide care and supervision to the clients.

Personnel Records/Staff Training: Administrator certificate expires 6/25/2025. Four (4) staff files were reviewed. Staff have criminal background clearance, health and TB clearance, and 1st Aid/CPR training. Proof of in-service training that includes HCBS Final rule was observed in staff files.

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