Facility Evaluation Report

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Required- 1 year visit. LPA met with Ronnie Chua, Administrator and explained the purpose of the visit. The facility is Enhanced Behavioral Home/ARF licensed to care for Developmentally Disabled Adults, ages 18 through 59, (4) ambulatory of which (3) may be non ambulatory. Non ambulatory clients in bedrooms 1, 2 & 3. All clients residing at this facility receive case management services provided by San Gabriel Pomona Regional Center. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. Staff are adhering to infection control requirements. Administrator reviewed and updated the Emergency Infection Control plan and made available to staff and clients.

Physical Plant/Environment Safety: The facility is a single story home located in a residential neighborhood, contains a total of (4) client bedrooms, (2) full bathrooms, a living room, den/activity area, office, kitchen, dining area, backyard, and attached garage. Currently, there are (4) clients living in the facility. The interior and exterior physical plant was inspected. Client bedrooms were toured. Each bedroom has a smoke detector, bed, linen, dresser, light, chair and sufficient closet space. Bathrooms have non-skid materials and contained hygiene supplies including liquid soap, paper towels, and toilet paper. Exit doors are free of any obstruction and there are no pools or large bodies of water. Backyard was inspected and area provides a shade with outdoor furniture. Kitchen knives, sharps objects, cleaning supplies and toxic substances are locked and inaccessible to clients. LPA observed a fire extinguisher near the kitchen which was last serviced on 04/04/2025. Smoke alarms and carbon monoxide were tested and operable. There are no surveillance camera in the home. Water temperature readings were tested in both bathrooms and measured within the required 105 - 120 degrees Fahrenheit. Bathroom #1 measured at 106.7 deg F and bathroom #2 at 108.8 deg F. Disaster drills are conducted monthly on each shift. Last fire drill was conducted on 10/29/2025.

Operational Requirements: All clients in the facility are ambulatory which is within the fire department requirement. The clients can attend the community events if they have the opportunity or chance. Surety Bond is valid, insured in the amount of $2000. The facility has a patio in the backyard with table and chairs for clients to utilize the outdoor activity.