Facility Evaluation Report

Licensing Program Analyst (LPA) Wong conducted the unannounced Annual Inspection and met with Administrator John Wilson who allowed the entry of the facility and explained the reason of today's visit and will be using the Compliance And Regulatory Enforcement (CARE) Tools to inspect the facility. The facility is licensed for age range 18 through 59 and ambulatory only. The facility is vendorized as a Specialized home with San Gabriel Pomona Regional Center.

The following domains were reviewed during today's annual required visit which included: infection control, physical plant and environmental, operational requirements, staffing, personnel records-training, client rights- information, client records-incident reports, food service, health related services, incidental medical services, disaster preparedness and emergency intervention.

1. Infection Control: The facility has an approved infection control plan and sufficient PPE supplies in place. The facility staff continue to practice hand washing and using gloves in the facility. Staff would clean and disinfect once a day or more often for high touched surfaces area.

2. Physical Plant and Environmental Safety: The facility is a single story house and located in a residential neighborhood area. The facility includes: dining area, living room, kitchen, four clients bedrooms and two client's bathrooms and a detached garage. Each client's bedroom has one bed, chair, drawer, night stand and required furniture and beddings and sufficient lighting and closet space. The two client's bathrooms are clean, sanitary and in a good working condition. The two client's bathrooms hot water temperature were tested from 116 degrees F to 120 degrees F. which are within the Title 22 regulation. All the kitchen appliances are working properly. All the sharp knives and utensils are stored and locked in the cabinet next to the dining table. The cleaning supplies are stored and locked in the cabinet next to the bathroom#2. The extra personal hygiene products are stored and locked in the cabinet next to the bathroom and the hallway cabinet. The extra linen and towels are stored in the hallway cabinet. LPA inspected the carbon monoxide detectors and they are all interconnected and they are working well. The facility has a telephone services on the premises. The facility has a hallway night and staff will turn on the light during the night time so client can access the non-private bathroom. The passageway, walkway and patio are free of obstruction.