Facility Evaluation Report

At around 9:20 am, Licensing Program Analyst (LPA) Luisa Fontanilla arrived unannounced to conduct annual inspection and met with staff Mary Beatriz Aglubat. LPA explained to Aglubat the purpose of the visit. Area Director Jasmine Williams was informed about the visit. Williams arrived at 10:08 am.

During the visit, LPA observed one client and two direct support personnel DSPs on shift. There was sufficient lighting and passageways were observed free from obstruction. No bodies of water were observed. Hot water measured 114.6F. Smoke detector and carbon monoxide were tested and observed functional. There was sufficient supply of perishable and non-perishable foods. Last fire drill was conducted on 6/24/2025. Fire extinguisher

that appeared full and was last serviced on 9/11/2024 was observed. First aid kit was observed to be complete.

At 10:20 AM, LPA reviewed 3 client files and 3 staff files. At 11:30 am, LPA reviewed medication and Medication Administration Record with Aglubat.

Deficiencies were observed (refer to Lic 809D).

Exit interview was conducted with Williams and Appeal Rights was provided.