Facility Evaluation Report

On 10/14/25, Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced annual required visit. LPA met with the Administrator, Mariel Ventura and explained the purpose of today’s visit. The purpose of today’s visit was to conduct the required annual inspection, using the new Care Tool. The facility is licensed to serve 4 developmentally disabled clients (age 18-59); four (4) ambulatory of which two (2) can be non-ambulatories. The census is currently 3 with one (1) respite client.

164th is a one-story structure located in a residential neighborhood. The facility consists of (4) bedrooms, (1 1/2) bathrooms, living room, kitchen, dining area, shaded patio, washer and dryer on the back deck and the garage is used for storage. Facility maintains all required posting throughout the facility.

LPA conducted a records review of (4) client records, and (4) staff records. All client & staff records were complete. LPA Shirley and Mariel walked throughout the facility and all common areas such as the living room, dining room, and outdoor patio were all observed. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked . Bathrooms were found to be within Title 22 regulations and were clean and operational. The water delivered at 118 F.

LPA observed that there is ample seating and space for all clients. All walkways were clean, and clear of obstructions and hazards. All areas have ample lighting. Smoke/ Carbon Monoxide detectors were operable. The last fire/emergency drill was conducted on 9/10/25. There is (1) charged fire extinguisher last serviced on 3/2025. Exterior areas are clean and clear of obstructions and hazards and there are no bodies of water present.

No deficiencies were cited during this inspection visit.

An exit interview was conducted, and a copy of this report was provided to the Program Manager, Mariel Ventura.