Facility Evaluation Report

Licensing Program Analyst (LPA) Daniel Konishi conducted the required annual inspection. LPA arrived unannounced and met with Administrator Melissa Vazquez allowed the entry of the facility and assisted with the visit. The purpose for the visit was explained. The facility is licensed for Age Range 18 through 59. 4 ambulatory which 3 maybe non-ambulatory. Non-ambulatory in bedrooms 1,2 &3. The facility is vendored as an Enhanced Behavioral Support Home (EBSH) with San Gabriel Pomona Regional Center. There are currently 4 clients in the facility.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and only inspected those domain:

1. Infection Control: The facility staff are using appropriate hand hygiene and wearing gloves while assisting clients. Staff are cleaning and disinfecting at least once a day and more often for high touched surfaces. Facility has sufficient PPE supplies and has an Infection Control Plan.

2. Physical Plant and Environmental Safety: The facility is a single story house and located in a residential neighborhood area. The facility includes: Living room#1, Living room#2, dining area, kitchen, open staff office, four clients bedrooms, two clients bathrooms and an attached garage. Each client bedroom has one bed, one chair, one drawer, one night stand, required furniture and beddings and sufficient lighting and closet space. The two client bathrooms are clean, sanitary and in a good working condition. The hot water in two client bathroom were read at 105 degrees F. which is within Title 22 regulation. All the knives and sharp utensils are stored and locked in the medication cart. All the cleaning supplies and chemicals are stored and locked in the cabinet near the living room#1. The extra personal hygiene products are stored and locked in the cabinet in the garage.