Facility Evaluation Report

Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year visit. The purpose of the visit was explained to Administrator Mila Lafiguera. Assistant Administrator Lilibeth Esguerra- Nuckolls arrived shortly after. The facility is licensed as an Adult Residential Facility for six (6) [2 non-ambulatory & 4 ambulatory] developmentally disabled adults ages 60 and over. The facility is licensed as a level 4A ARF vendored by San Gabriel/Pomona Regional Center. The following 12 Care Compliance and Regulatory Enforcement (CARE) tool domains were utilized during the inspection.

Infection Control: The Infection Control Plan was reviewed. The facility has sufficient supply of Personal Protective Equipment (PPEs).

Physical Plant/Environment Safety: The facility is a single story home located in a residential neighborhood. It consists of 3 resident bedrooms, 1 office room, 1 staff room, 2 bathrooms, kitchen, dining room, living room, outdoor patio, and an attached garage with laundry area. 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. The facility has one (1) fully charged fire extinguisher and a fire pull alarm in the living room. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. The facility has a 1st Aid Kit and Manual.

Cleaning supplies, knives, and toxic substances were observed unlocked and accessible to residents under the kitchen sink. It was determined the locking mechanism is faulty. A repairman arrived during the visit.

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. Special equipment and supplies are not used by residents. The Surety Bond is current with expiration date of 7/9/2025.

Staffing: A total of 7 staff members provide care and supervision to the clients.