Facility Evaluation Report

On 05/09/25, at 9:20am, Licensing Program Analyst (LPA) Perry Scott conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Kimberly Moss, Direct Support Professional, and Jessica Diaz, Program Director, and the purpose of today’s visit was explained. The facility is licensed to operate for (3) ambulatory, of which two (2) may be non-ambulatory developmentally disabled adults ages 18 through 59. Currently, the home has (3) clients. The clients are Harbor Regional Center clients. None of the clients have Restricted Health Care Conditions, and none are utilizing postural supports or protective devices. The facilities annual fees are current.

The facility is a single-story structure located in a residential neighborhood. It consists of (3) client bedrooms, (2) bathrooms, living room, family room, kitchen, laundry room, backyard, and an attached garage.

LPA conducted a records review of (3) client records, (4) staff records, (3) clients Personal & Incidental Records and reviewed the facility disaster plan. All client & staff records were complete. The facility disaster plan was current and in compliance with Title 22 at the time of visit. LPA reviewed (3) client Medication Administration Records and did not observe any discrepancies at the time of visit.

At 10:00am, LPA and staff toured the physical plant. There are no bodies of water or firearm/ammunition on the premises. All client rooms were checked. Beds and bedding were in good condition, adequate lighting was provided, and adequate storage for client personal belongings was observed. Walls and floors were in good repair.