Facility Evaluation Report

Licensing Program Analyst (LPA) Sakinah Madyun conducted an unannounced continued Annual Inspection visit on 09/19/25 at approximately 2:35pm. LPA was met by Caregiver Nicole Lian-Carter and explained the reason for the return visit. The facility is licensed to serve clients of age 18 to 59 years old Developmentally Disabled Adults, and has a fire clearance approved for four (4) ambulatory and two (2) non-ambulatory clients. The facility is a single story home located on a residential street.

During today's continued annual visit, LPA Madyun observed the following:

Staffing/Personnel Files: LPA completed reviewing six (6) of seven (7) staff files. LPA interviewed one (1) of seven (7) staff. Due to time constraint LPA will return a later date and time for a continuation visit to conduct staff interviews.

Client Records: Due to time constraint LPA will return a later date and time for a continuation visit to conduct client interviews.

Inspection tool completed. No deficiencies are being cited today. Exit interview conducted with Nicole Lian -Carter and a copy of this report was provided.