Facility Evaluation Report

Licensing Program Analyst (LPA) Evelin Rios conducted an unannounced Annual Required visit and inspection of this facility. LPA met with the administrator Maria Cecilia Royo and LPA explained the reason for the visit. In the facility LPA met three (03) out of four (04) clients. Clients were getting ready to be picked up for their community programs.

At approximately 8:20 a.m., LPA conducted a facility file review . The facility is licensed to serve two (2) ambulatory and two (2) non-ambulatory clients, for a total capacity of four (4) . Administrator certification is current. LPA reviewed current Surety bond and Certificate of Liability Insurance. LPA reviewed facility's annual emergency disaster training that was conducted 01/10/2025. Last fire drill was conducted on 05/14/2025. Client roster and 24 hour staff schedule were reviewed to ensure they are current and complete.

Staff and Records : At 8:54 a.m., LPA Rios reviewed four (04) two staff records to enure compliance with licensing forms. At approximately 9:05 a.m., LPA reviewed four (4) out of four (04) client records to ensure they were current and complete.

At 9:43 a.m., LPA Rios, along with the administrator, conducted a physical plant tour of the facility—inside and out—and made the following observations. LPA observed required postings on facility wall along with a sign in log for visitors and residents by the entry. LPA observed a closet by the entrance that stored extra linens, emergency food, water and PPE.

Office: Client, staff records, centrally stored medication, medication records and first aid kit with manual are kept in the office inside locked cabinets. LPA observed an extra refrigerator. (Continue to LIC809-C)