Facility Evaluation Report

Licensing Program Analyst (LPA) Sakinah Madyun conducted an unannounced continued Annual Inspection visit on 09/19/25 at approximately 9:10am. LPA was met by Caregiver Jerome Unica and explained the reason for the return visit. Administrator Shelly Yamashiro and Caregiver/Designated Administrator Rathany Suy arrived shortly after. The facility is licensed to serve clients of age 18 to 59 years old and has a fire clearance approved for six (6) non-ambulatory of which one (1) may be bedridden and approved hospice waiver for three (3) clients. There were one (1) resident under hospice care.

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

Bathrooms: LPA retested bathrooms after water adjustment and temperature measured at 112.2-112.9 degrees Fahrenheit within the range of 105-120 degrees Fahrenheit.

Kitchen: LPA retested kitchen after water adjustment and temperature measured at 111.2 degrees Fahrenheit within the range of 105-120 degrees Fahrenheit.

Staffing/Personnel Files: LPA completed staff interviews and files.

Client Records / Centrally Stored Medications: LPA observed six (6) of six (6) client files and reviewed the additional four (4) of six (6) clients medications and logs.

Inspection tool completed. No deficiencies are being cited today. Exit interview conducted with Shelly Yamashiro and a copy of this report was provided.