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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600025
Report Date: 12/06/2021
Date Signed: 12/06/2021 11:17:16 AM

Document Has Been Signed on 12/06/2021 11:17 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:BEST FRIENDS SOCIAL CENTER INC.FACILITY NUMBER:
198600025
ADMINISTRATOR:VICTOR STEWARTFACILITY TYPE:
735
ADDRESS:728 E. MCKINLEY AVENUETELEPHONE:
(909) 629-9177
CITY:POMONASTATE: CAZIP CODE:
91767
CAPACITY: 6CENSUS: 6DATE:
12/06/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:S-1TIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Elizabeth Irra conducted an unannounced Required-1 year visit focusing on COVID-19 Infection Control Practices. LPA met with S-1 and explained the purpose of today's visit. LPA toured the facility grounds.

This home consists of (3) bedrooms, 2 full-bathrooms, living room. kitchen, dinning area, laundry room, office and an detached garage. There are (6) clients residing at this home. All clients receive case management services provided by San Gabriel Pomona Regional Center.

The following were observed/inspected:
  • COVID-19 Infection Control Practices (including signs) were observed at the entrance of this facility, in all common rooms and hallways.
  • Signs are posted to promote hand washing, cough/sneeze etiquette, and physical distancing.
  • Medication reviewed.
  • Sufficient supply of perishable for 2 days and non-perishable foods for 7 days were observed. Additional food supply is stored inside the garage.
  • PPE supplies observed. They are stored inside the office and inside the detached garage.
  • All common areas have a hand sanitizers.
  • Staff responsible for direct care and supervision were observed wearing masks.
  • Clients were socially distanced according to local public health guidelines.
  • Per S-1, all (6) clients are fully vaccinated. COVID Booster to be determined.
  • Per S-1, (4) staff are fully vaccinated and (3) staff receive COVID testing on a weekly basis. COVID Booster to be determined.

Exit interview conducted, a copy of this report and Appeal Rights were provided to S-1.
SUPERVISORS NAME: Christine Yee
LICENSING EVALUATOR NAME: Elizabeth Irra
LICENSING EVALUATOR SIGNATURE: DATE: 12/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/06/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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