Facility Evaluation Report

On 07/29/2023 at 12:00 PM, Licensing Program Analyst (LPA) Jose Calderon conducted an unannounced annual inspection visit at the Hazelbrook Home Facility. LPA Calderon was allowed entry into the facility by Administrator Cristina Serafico was asked questions regarding the full care tools control package (13) sections. Administrator Cristina Serafico took LPA Calderon temperature prior to entrance into the facility. The facility is licensed for three (3) adult clients with developmental disabilities. Currently, there are three (3) residents residing in the facility with developmental disabilities.

LPA Calderon explained to Administrator Cristina Serafico, the purpose of the one year (1) Annual Inspection visit, and escorted LPA Calderon on a tour of the entire inside and outside facility grounds. As part of the inspection, LPA Calderon reviewed: three (3) resident service records, three (3) resident medication records, six (6) staff records. LPA Calderon interviewed three (3) residents and three (3) staff members for visit. LPA Calderon inspected the inside facility and outside grounds to include all common areas. The facilities’ last fire drill was conducted on 05/24/2023 . The one story residential home consists of three (3) resident bedrooms, two (2) resident bathrooms, living room, dining room, family room, kitchen, office area, attached garage with washer and dryer/ storage area, backyard with table and chairs. No weapons are stored in the premises. Kitchen was inspected and observed to be clean and operational. A two day (2) supply perishable and seven day (7) supply of non-perishable foods are present in the facility. Emergency Water seven day (7) supply is found in the garage.