<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602952
Report Date: 07/27/2023
Date Signed: 07/27/2023 03:56:16 PM

Document Has Been Signed on 07/27/2023 03:56 PM - 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:A AND M AURORA HOME CAREFACILITY NUMBER:
198602952
ADMINISTRATOR:JOSEPH ESTANISLAOFACILITY TYPE:
735
ADDRESS:555 AUORA DRIVETELEPHONE:
(909) 399-0693
CITY:CLAREMONTSTATE: CAZIP CODE:
91711
CAPACITY: 4CENSUS: 4DATE:
07/27/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Joseph Estanislao, administratorTIME COMPLETED:
03:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Tao conducted an unannounced annual inspection visit. Upon arrival, LPA met with Joseph Estanislao, Administrator and discussed the purpose of today's visit. All four (4) clients receive case management services provided by San Gabriel Pomona Regional Center. Facility is licensed to serve clients ages from 18 to 59, four (4) non-ambulatory and delayed egress is approved. License fees are current.

Facility is a single family house, consisted of four (4) bedrooms, two (2) full bathrooms, a living room, a dining area, a kitchen, laundry area, a detached garage and an outdoor activity area in the back yard. All outdoor and indoor passageways are free from obstruction.

Common areas were observed for the ability to safely serve the needs of the clients. All client rooms were furnished with appropriate furniture for clients’ comfort. The bathrooms were furnished with grab bars and nonskid surfaces. Hot water temperature was measured at 106.5 degrees Fahrenheit which was within Title 22 Regulation guidelines. Adequate linen and personal hygiene supplies were observed. Facility maintained a comfortable temperature for clients. Sufficient supply of perishable and non-perishable foods were observed. Back yard activity area was a shaded area with chairs and free of debris/ hazard. Smoke and carbon monoxide detectors were operable. The last Fire/ Emergency Drill was conducted on 7/3/23.



Fire extinguishers were fully charged and the last services was on 1/19/23. Medications were centrally stored, locked and the records were current. Hazardous items, knives and sharp items were locked and inaccessible to clients. Delayed egress was working.

No deficiencies were cited per California Code of Regulations, Title 22.

Exit conference was conducted with administrator. This report, LIC 809 was provided to administrator.
SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Bonnie Tao
LICENSING EVALUATOR SIGNATURE: DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/27/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1