Facility Evaluation Report

On 04/21/2025 at 1:00pm , Licensing Program Analyst (LPA) Zina Brown conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Martel Plotnick, Administrator and the purpose of today’s visit was explained. The facility is licensed to operate for (3) non-ambulatory, adults ages. Currently, the home has (3) clients. The clients are Harbor Regional Center clients. One (1) of the clients have Restricted Health Care Conditions and none are utilizing postural supports or protective devices.

The facility has a current administrator certificate (#7029040735) for Martel Plotnick effective as of 01/24/2025. The facility fees paid in full. LPA provided pin #496003 with the option for the facility to make an payment online. The facility has liability insurance with AIU Insurance Company (NAIC# 19399) with each occurrence/general aggregate at $4,000,000 - (policy #3752210) effective date 10/01/2024 - 10/01/2025.

The facility is a one (1) story home located in a residential neighborhood. The property consists of the following: 4 client bedrooms, 2 bathrooms, 2 living room, laundry room with a washer and dryer, kitchen, dining room, attached garage, outdoor shaded area.

Between the hours of 1:15pm - 3:20pm LPA conducted a records review of (3) client records, (4) staff records, (1) clients Personal & Incidental Records and (3) Client Medication Administration Records and reviewed the facility disaster plan (conducted on 04.09.2025 at 10:52pm). All client & Staff records were complete. The facility disaster plan was current and in compliance with Title 22 at the time of visit. LPA did not observed any discrepancies at the time of visit.