Facility Evaluation Report

Licensing Program Analyst (LPA) Wong 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 Virelina Elopre, DSP at the facility and was granted access into the home. Administrator Peter Munzon arrived shortly to assist the annual inspection. The facility is vendored through the San Gabriel/Pomona Regional Center

1. Infection Control: Facility has an infection control plan in place. The facility staff continue to practice hand washing and disinfect the facility at each shift and Facility has sufficient PPE supplies.

2. Physical Environmental and safety: The facility is a single story house and located in a residential neighborhood area. The facility includes: dining area, kitchen, living room, three client's bedrooms and two and half bathrooms, linen closet, staff office and a detached garage. The three client's bedrooms have two beds, two chairs, two drawers, night stands, required beddings and furniture and sufficient lighting and closet space. The two and half bathrooms are clean, sanitary and in a good working condition. The hot water temperature tested in those two and half bathrooms were tested between 110.4 and 111.9 degrees F which is within Title 22 regualtion. The sharp knives and utensils are stored and locked in the kitchen drawer. All the kitchen appliances are working properly. All the chemicals and cleaning supplies are stored and locked in the cabinet in the garage. The extra personal hygiene products are stored in the staff office. The hallway light is usually on during the night time for client to access the non-private bathroom and the bathrooms have a night light too. LPA inspected the carbon monoxide detectors and they are interconnected and they are working well. The facility has a telephone service on the premises.

3. Operational Requirement: Facility is licensed for 5 ambulatory and 1 non-ambulatory in master bedroom only. Currently the facility only have one client is non-ambulatory which is within the fire clearance requirement. The last fire drill was conducted on 4/1/24. The client in the facility would be able to attend community activities if there's an opportunity.