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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 366407984
Report Date: 04/29/2022
Date Signed: 06/10/2022 04:13:40 PM


Document Has Been Signed on 06/10/2022 04:13 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, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507



FACILITY NAME:LAMPPOST RESOURCE GROUP, INC.FACILITY NUMBER:
366407984
ADMINISTRATOR:SANZO, WILLIAM IIFACILITY TYPE:
735
ADDRESS:1211 WEDGEWOOD COURTTELEPHONE:
(951) 213-9993
CITY:RIALTOSTATE: CAZIP CODE:
92376
CAPACITY:6CENSUS: 4DATE:
04/29/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:32 PM
MET WITH:House Manager -Benilda LumberaTIME COMPLETED:
02:57 PM
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Licensing Program Analyst (LPA) Anna Bueno conducted an unannounced visit to the facility in order to conduct a required annual inspection, with an emphasis on infection control, due to the COVID-19 pandemic. LPA identified herself to staff, who was also informed of the purpose of the visit. House manager Benilda Lumbera arrived shortly.

LPA and house manager toured the inside and outside of the facility. During the inspection, LPA interviewed Lumbera regarding the facility's infection control measures and inspected the facility for regulatory compliance. LPA observed appropriate postings in the facility, including COVID-19 symptoms postings and visitation policies, which were in accordance with the Department's guidelines. LPA observed that the facility was also equipped with sufficient hand hygiene supplies, sufficient cleaning and disinfecting provisions, and a supply of Personal Protective Equipment (PPE). The facility has a designated infection control lead person who has been tasked with tracking all COVID-19 cases and/or suspected cases and that staff are trained in the facility's infection control measures. The facility has a plan in place which follows Community Care Licensing Division guidelines for COVID-19 testing, isolation, and properly caring for clients with COVID-19 positive results and/or exposures. The facility also has a plan in place to monitor residents regularly for any changes in condition and to subsequently notify the resident's physician and emergency personnel in the event the resident presents any COVID-19 symptoms.

LPA observed that the facility appeared to be meeting operational requirements. LPA observed that all utilities and appliances were functioning properly and all passageways clear of obstruction, including emergency exits. The facility was equipped with sufficient food supply and emergency supplies. All areas of the facility, including client bedrooms and restrooms, appeared clean and in good repair. *****LIC 809-C*****
SUPERVISOR'S NAME: Nedra BrownTELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Anna BuenoTELEPHONE: 951-204-4307
LICENSING EVALUATOR SIGNATURE:
DATE: 04/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/29/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME: LAMPPOST RESOURCE GROUP, INC.
FACILITY NUMBER: 366407984
VISIT DATE: 04/29/2022
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LPA observed that medications and sharps were kept inaccessible to clients in care. LPA observed no apparent health and safety risks at the time of visit. LPA observed no apparent health and safety risks at the time of visit. Technical Advisories were given to remind staff of masking guidelines and N-95 respirator fit testing, which are in accordance with the Department's guidelines.

An exit interview was conducted where a copy of this report and LIC-9102As were reviewed and provided to Benilda Lumbera, house manager.
SUPERVISOR'S NAME: Nedra BrownTELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Anna BuenoTELEPHONE: 951-204-4307
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2022
LIC809 (FAS) - (06/04)
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