Facility Evaluation Report

Licensing Program Analyst (LPA) Noemi Galarza made an unannounced Required - 1 year annual inspection visit. The purpose of the visit was explained to Administrator Josefina Bernal. The facility is licensed as a level 4C Adult Residential Facility (ARF) that serves developmentally disabled residents under age 59, and is vendored by San Gabriel/Pomona Regional Center. The facility is a single story home located in a residential neighborhood. It consists of 3 client bedrooms, 1 office room, 2 bathrooms, dining room/kitchen, living room, outdoor patio, and an attached garage. The following 12 (CARE) tool domains were utilized during the inspection.

Infection Control: The facility has an Infection Control Plan on-site.

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. Smoke and carbon monoxide detectors were tested and are operational. The facility has a fire pull-alarm alert system and one (1) fully charged fire extinguishers. Hot water temperature readings measured between the required 105 - 120 degrees Fahrenheit. Storage areas for cleaning solutions/toxins, knives, and hazardous items were inaccessible to clients.

Operational Requirements: Fire clearance is approved for four (4) ambulatory and two (2) non-ambulatory residents. Care and supervision to meet the clients needs was observed. No special equipment and supplies are used by clients. Facility manages residents P & I monies. Facility has a current Surety Bond that expires 8/30/2025.

Staffing: A total of 10 staff members provide care and supervision to the clients.

Personnel Records/Staff Training: Five (5) staff files were reviewed. Criminal background clearance, continuing education of DSP training, 1st Aid/CPR training, and health screening/TB clearance. No emergency training is required.