The facility is a single-story home located in a residential neighborhood. All clients residing at the facility receive case management services through the San Gabriel/Pomona Regional Center. The facility is licensed to serve six (6) clients, both ambulatory and non-ambulatory, with Bedroom One (1) approved for two (2) non-ambulatory clients.

FACILITY TOUR AND OBSERVATIONS:

Personal Rights postings were observed in a common area. Residents had access to personal space, privacy, and adequate storage. No firearms/weapons were present.

Physical Plant

The facility is a one-story residential home consisting of four (4) bedrooms, including one (1) staff bedroom, a kitchen, dining room, living room, two (2) bathrooms, and a laundry area with a backyard patio. The backyard patio was furnished with patio furniture and an umbrella to provide shade. All three (3) client bedrooms contained the required furnishings, including a bed with a clean mattress, linens, a dresser, a chair, and adequate lighting. Additional clean linens and towels were available in the client rooms, with extra supplies stored in the hallway closet. All furniture was observed to be in good condition. The bathrooms had working fixtures and were equipped with non-skid mats. Hot water in the bathrooms was measured within the required range of 105–120°F. Smoke and carbon monoxide detectors were functional, and a fully charged fire extinguisher was mounted in the kitchen area. All exits were clear, and there were no bodies of water on the premises.

(Continued on 809C)

• Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

• Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

Refrigerators and freezers were maintained at proper temperatures, with refrigerators at or below 40°F and freezers at 0°F. The facility maintained a sufficient supply of at least two (2) days of perishable food and seven (7) days of non-perishable food. An additional refrigerators located in the garage were stocked with fresh produce, proteins, and pantires were stocked with dry goods.

Knives were secured in a locked cabinet in the kitchen. Cleaning supplies were stored in a locked cabinet in the laundry room area and were maintained inaccessible to clients at all times.

Health-Related Services & Records:
Three (3) client files were reviewed and contained current required documents (Admissions Agreements, Pre-Placement Appraisals, Consents, Needs/Service Plans, Physician’s Reports with TB/ambulatory status, Rights acknowledgments, and IPPs). Medical/dental care was current. Three (3) medications were reviewed; medications are centrally stored in kitchen cabinet, locked, and labeled. MAR logs were current.

Disaster Preparedness:
Last fire/earthquake drill was conducted on March 01, 2026, with logs available. LIC 610D Emergency Disaster Plan was posted in the living room area. Emergency supplies (water, food, flashlights, batteries, first aid) were observed.

Personnel Records & Training:
Three (3) staff files were reviewed and included criminal record clearances, CPR/First Aid, DSP training, and TB screenings. Administrator Certificate for Elizabeth Stacy was valid through February 14, 2027. Staffing ratio met requirements.

An exit interview was conducted with the Administrator Elizabeth Stacy. During the inspection, the facility was observed to be following Title 22, Division 6 regulations. No deficiencies were cited at this time. A copy of the report was provided.