Facility Evaluation Report

Licensing Program Analyst (LPA) N. Galarza conducted a case management visit to inspect the facility for a capacity decrease from six (6) [4 ambulatory & 2 non-ambulatory] to four (4) [2 ambulatory & 2 non-ambulatory] clients. The facility is licensed to serve developmentally disabled clients (ages 18 through 59 years). The fire safety inspection for a capacity decrease was granted by Inspector R. Beihl of the West Covina Fire Department on 2/2/2022.

A tour of the facility included Bedroom #1 - (non-ambulatory; double), Bedroom #2 – private, Bedroom #3 – private, Room #4 is a staff room, kitchen, living room, dining room, activity room, backyard, garage, and two (2) bathrooms were observed. The last Annual/Required visit was conducted on 9/22/2022.

LPA observed 2 clients living in the home. Bedroom # 3 still has 2 beds. Administrator agreed to send pictures showing the removal of the extra bed. Bedroom #1 had a new sliding door installed for the fire clearance, and the old sliding door was observed in the backyard. Administrator will submit picture proof the debris was removed from the backyard.

A new license will be generated and mailed once the capacity decrease has been approved by Manager.

An exit interview was conducted with Administrator Jocelyn Manalo. A copy of the report was issued.