Facility Evaluation Report

Licensing Program Analyst (LPA) Christian Gutierrez conducted an unannounced annual visit at the facility using the CARE Tool. LPA Gutierrez met with LVN Rose Custodio and explained the reason for the visit Ronald Yuson (Administrator) arrived shortly.

The facility is an Adult Residential Facility for Persons with Special Health Care Needs (ARFPSHN) it is licensed to serve 5 bedridden adults and is vendorized through South Central Regional Center. The home currently has three (3) clients. The facility is a single-story home located in a residential area. It consists of 5 client bedrooms, 2 bathrooms, kitchen, living room, dining room, patio, front yard, backyard, and an attached garage.

LPA toured the facility and observed the following: Each client bedroom has the required furniture and bedding. The Smoke and carbon monoxide detectors were observed throughout the facility and are properly operating. The facility has a sprinkler system in place. The facility has three (3) fully charged fire extinguishers which are kept in kitchen, living room, and garage. Cleaning supplies and toxic substances were observed to be inaccessible in locked kitchen drawers. Freezers are maintained at a temperature of 0-degree F and the refrigerators at a maximum of 40 degrees F. Facility was observed to have sufficient supply of 2 days perishable & 7 days non-perishable foods. There are no firearms or weapons stored at the facility. The hot water temperature in the bathrooms were measured between the required range of 105-120 degrees F. The clients’ bathrooms have the required equipment for clients. Clean towels and extra clean linen were observed in the hallway cabinet. The facility does not have a swimming pool or bodies of water on the premises There is a shaded seating area for the clients outside. Facility has an emergency generator located in back yard. Passageways and exits are free of obstruction.