Facility Evaluation Report

On 7/8/26, Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced annual required visit. LPA met with the Administrator, Cristina Serafico 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 (3) Non-Ambulatory Adults only. There are (3) clients in placement. The facility’s annual fees are current.

The Hazelbrook Home is a single-story structure located in a residential neighborhood. The facility consists of (3) bedrooms, (2) bathrooms, living room, kitchen, dining area, den, and office area and a detached garage. The laundry room containing the washer and dryer is located in the hallway. Facility maintains all required posting throughout the facility.

LPA conducted a records review of (2) staff records and (3) client records which contained the required documentation, and (3) client medications. LPA Shirley reviewed the Liability Insurance and Surety Bond and the Emergency Disaster Plan. LPA Shirley and Christina walked throughout the facility and all common areas such as the living room, den and dining room were all observed. The first aid kit was checked and fully stocked . Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature delivered at 111.2 F.

LPA observed 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. There is (1) charged fire extinguisher that was last serviced 7/6/26. 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 Administrator, Christina Serafico.