Facility Evaluation Report

Licensing Program Analyst (LPA) Noemi Galarza made an unannounced annual inspection visit. The purpose of the visit was explained to DSP Estrella Joaquin. Administrator was explained the purpose of the visit telephonically. The facility serves developmentally disabled residents under age 59. The facility is licensed as a level 4G Adult Residential Facility (ARF) vendored by San Gabriel/Pomona Regional Center. The facility is a single story home located in a residential neighborhood consisting of 4 bedrooms, kitchen, living room, dining room, activity room, backyard, garage, and two (2) bathrooms were observed. The following 12 (CARE) tool domains were utilized during the inspection

Infection Control: The facility has an Infection Control Plan in place.

Physical Plant/Environment Safety: 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. Smoke and carbon monoxide detectors were tested and are operational. The facility has (2) fully charged fire extinguishers. Storage areas for cleaning solutions/toxins, knives, and hazardous items were inaccessible to clients. Hot water temperature readings did not measure between the required 105 - 120 degrees Fahrenheit; readings were 129.7- 129.9 DF. Client (C1 & C2's) beds did not have mattress pads.

Operational Requirements: Fire clearance is approved for two (2) ambulatory and (2) non-ambulatory clients. Care and supervision to meet the clients needs was observed. No special equipment and supplies are used by clients. Facility manages residents P & I monies. The Surety Bond is current. P & I money is not kept separate from other clients in care and some P & I ledgers did not have balance amounts listed.

Staffing: A total of three (3) staff members provide care and supervision to the clients.

Personnel Records/Staff Training: Two (2) staff files were reviewed. Criminal background clearance, TB clearance, in-service training, 1st Aid/CPR training, and health screening. Administrator file was not available for review.

Administrator certificate expired 11/29/2023. Ms. Manalo sent recertification documents late (not 90 days prior to expiration) until 5/28/2024. Certification is currently pending.