Facility Evaluation Report

On 08/22/2024 at 10:20am, Licensing Program Analyst (LPA) Zina Brown conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with the Elias Penones (House Manager) and the purpose of today’s visit was explained. The facility is licensed to operate for (4) ambulatory only . Currently, the home has (4) ambulatory clients. The clients are Harbor Regional Center clients. One the clients have Restricted Health Care Conditions and none are utilizing postural supports or protective devices.

The facility has a current administrator certificate (7008340735) for Dexter Dizon application received 07/17/2025. The facility fees are current.

The facility is a one story home located in a residential neighborhood. The property consists of the following: four (4) client bedrooms, one (1) in house staff bedroom, (2) bathrooms, family room with a snack pantry, living room, kitchen, dining room, attached garage with storage and an additional deep freezer, a washer and a dryer and an outdoor shaded area.

Between the hours of 10:43am - 11:29am, LPA conducted a records review of (4) client records, (5) staff records, (4) clients Personal & Incidental Records and reviewed the facility disaster plan. The facility disaster plan was current and in compliance with Title 22 at the time of visit. Between the hours of 10:28am - 10:43am, LPA reviewed (3) Client Medication Administrations Records.