Facility Evaluation Report

On 9/22/25 at 12:15 PM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Backup Administrator, Antonino De Dios Jr and explained the purpose of the visit. The facility’s fire clearance was approved for 6 non-ambulatory with a hospice waiver of 2.

LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 6 total bedrooms which 4 bedrooms are occupied by the clients and 2 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water. A comfortable temperature for clients is maintained at 70 degree Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. Hot water temperature in the shared clients’ bathroom was measured at 109.7 degree Fahrenheit. All toilets, hand washing and bathing are safe, sanitary and in operating condition. The supply of extra hygiene’s were available for clients. There is a minimum of one week supply of non-perishable and 2-day perishables food supply.

Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 10/23/2024. Emergency Disaster Drill was last posted on 9/22/25. First aid kit was observed to be complete. Fire drill was last conducted on 5/20/2025.

At 12:30pm, 6 of 6 clients records were reviewed. At 1:15pm, 3 staff records were reviewed and 3 of 3 have current first aid training and associated to the facility. LPA observed P&I log to be correct and Facility has a sufficient surety bond.

No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.