Facility Evaluation Report

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Required- 1 year visit. LPA met with Nwachukwu Nwokoro, DSP II and Nkechi Alozie, DSP II and explained the purpose of the visit. Administrator, Linda Williams was called on the phone and arrived at 1:20pm to assist LPA. T he facility is licensed to care for Developmentally Disabled Adults, ages 18 through 59, (4) ambulatory only. All clients residing at this facility receive case management services provided by San Gabriel Pomona Regional Center. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. Staff are adhering to infection control requirements. Administrator reviews/updates the Infection Control plan annually.

Physical Plant/Environment Safet y: The facility is a single story home located in a residential neighborhood, contains a total of (3) bedrooms, of which (2) are client bedrooms and (1) spare/covid room, (2) full bathrooms, a living room, dining area, office, kitchen, backyard, and attached garage. Currently, there are (4) clients living in the facility. The interior and exterior physical plant was inspected. Client bedrooms were toured. Each bedroom contained the required bed with bedding, mattress cover/sheets, blankets, bedspread, furniture, lighting and sufficient storage space. Bathrooms have non-skid materials and contained hygiene supplies including liquid soap and toilet paper. Exit doors are free of any obstruction and there are no pools or large bodies of water. Backyard was inspected and area provides a shade with outdoor furniture. Kitchen knives, sharps objects, cleaning supplies and toxic substances are locked and inaccessible to clients. LPA observed (1) fire extinguisher which was last serviced on 10/28/2025. Smoke alarms and carbon monoxide were tested and operable. Water temperature readings were tested in all bathrooms and measured within the required 105 - 120 degrees Fahrenheit. Fire/disaster drills are conducted monthly on each shift. Last drill was conducted on 01/08/2026.

Operational Requirements: All clients in the facility are ambulatory. Surety Bond is valid, expiring on 01/11/2027 and insured in the amount of $6000. Backyard has a c overed patio and equipped with chairs for clients to utilize during outdoor activity. *****REPORT CONTINUED ON LIC809-C*****