Facility Evaluation Report

Licensing Program Analyst (LPA), Antonia Alvizar - Ettima conducted an unannounced Required 1-year inspection at this facility at approximately 2:56 p.m. LPA was greeted by DSP's and LPA disclosed the purpose of the visit.

LPA conducted a tour of the physical plant at approximately 3:17p.m. to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

The common areas were observed for the ability to safely serve the needs clients. Living room, kitchen, dining area, three (3) bedrooms, two (2) bathrooms, detached garage with a laundry area, and outdoor areas. The common areas were checked for cleanliness and furniture was checked for functionality. Common areas observed to be sanitary and furnished appropriately. Clients where observed to be having snack, coloring and play board games.

Due to time constraints this required annual will be completed at a later time.

Exit interview conducted/Copy of report given