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. The purpose of the visit was explained to Assistant Administrator Marina Rios. There are four (4) ambulatory developmentally disabled residents in the home. The facility is licensed as a level 3 Adult Residential Facility (ARF) 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, Resident Rights/Information, Resident 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. Visitor screening is no longer in place. Resident bedroom's are designated as a COVID-19 isolation room if needed. Infection Control Plan and COVID-19 Mitigation Plan have been submitted.

The facility is a single story home located in a residential neighborhood that is licensed for four (4) ambulatory only developmentally disabled clients ages 18 - 59. The home consists of three (3) client bedrooms, one (1) staff room, 2 bathrooms, kitchen, dining room, living room, backyard patio area, and attached garage with laundry area.

The interior and exterior physical plant was inspected. Exit doors are free of any obstruction. Smoke and carbon monoxide detectors are operational. The facility has one (1) fully charged fire extinguisher. Cleaning supplies and toxic substances are inaccessible to residents.

Water temperature readings did not measure between the required 105 - 120 degrees Fahrenheit. Citation was issued.