Facility Evaluation Report

On 11/29/2023 at 2:00PM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced/announced to conduct 1-Year Annual Required inspection. LPA met with Licensees/Administrators, Domingo Lalaquit and Gianne Vizconde-Lalaquit and explained the purpose of the visit. The facility currently has no residents/clients.

LPA toured facility with Domingo and Gianne including but not limited to 3 bedrooms, 2 bathrooms, kitchen, common areas and backyard. Bedrooms and living rooms were equipped with the proper furniture. Bathrooms were equipped with grab bars and non-skid mats. Linens and hygiene supplies were observed inside a cabinet. There is sufficient lighting throughout facility. Room temperature was maintained at 60 degrees F and hot water temperature was measured at 119.2 degrees F. First-aid kit was observed to be complete. Smoke detectors and carbon monoxide were operational. Fire extinguishers was last serviced on 09/12/23 and 09/20/23.

Starting at 3:00 PM, Component III was completed and presented to Administrators/Licensees.

No issues noted during inspection. LPAs observed that facility is ready to be licensed. This report will be submitted to the Central Applications Bureau (CAB) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAB. Additional requirements may still be required.

Exit interview conducted and a copy of this report provided.