Facility Evaluation Report

Licensing Program Analyst (LPA) Alberto Lopez conducted an unannounced visit to the facility for the purpose of conducting the required annual inspection. LPA Lopez met with Ariel De La Cruz who allowed entry and Interim administrator Mohammed Shirazi arrived a short time later and assisted with the visit. LPA explained the purpose of the visit.

The facility is licensed to serve 4 ambulatory developmentally disabled clients aged 18 to 59. Currently, there are four (4) clients in placement. All four of the clients are now over 60 years of age.

The facility staff are using appropriate hand hygiene and wearing gloves while assisting clients. Staff are cleaning and disinfecting often for high touched surfaces. Facility has sufficient PPE supplies, an Infection Control Plan. Bathrooms have hand washing signs, soap and paper towels. Facility Administrator is adhering to infection control requirements.

Operational Requirements: Facility has proper fire clearance and shaded area for activities. Last fire drill was on 03/20/2026.

The home is in a residential area, the one story facility includes a living room, dining room, kitchen, laundry section, 4 client bedrooms, 2 restrooms, an unattached garage and indoor/outdoor activity areas.

Refer to LIC 809C for continuation of report.