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 DSP Merlin Pakingan. Administrator Josefina Bernal arrived shortly after. There are five (5) ambulatory developmentally disabled adults ages 18-59. The facility is licensed as a level 4C home vendored by San Gabriel/Pomona Regional Center.

The following 12 (CARE) tool domains were observed and reviewed: Infection Control, Physical Plant/Environment Safety, Operational Requirements, Staffing, Personnel Records/Staff Training, Client Rights/Information, Client Records/Incident Reports, Food Service, Health Related Services, Incident Medical and Dental, Disaster Preparedness, and Emergency Intervention.

Infection control practices and Personal Protective Equipment (PPEs) were observed. The facility is still screening visitors and encourages hand washing and self symptom check of staff and visitors. Each resident's bedroom is designated as a COVID-19 isolation room if needed. The facility has an Infection Control Plan and COVID-19 mitigation plan.

Facility is a single story home licensed for 6 ambulatory only clients. It is located in a residential area consisting of three (3) shared client bedrooms, 2 bathrooms, kitchen, dining room, living room, covered patio area, and laundry area in the attached garage.

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 are operational. The facility has one (1) fully charged fire extinguisher. Cleaning supplies and toxic substances are inaccessible to clients. The kitchen window and room 1 is missing a screen and room 3 has a torn screen. Citation was issued.

Water temperature readings did not measure between the required 105 - 120 degrees Fahrenheit. The reading were hot water temperature readings are 145.5, 141.8, 139.9 degrees Fahrenheit . Staff adjusted the water heater immediately. Citation was issued.