Facility Evaluation Report

Licensing Program Analyst (LPA) Daniel Konishi conducted an unannounced Required- 1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA was met by Joan Mimbala, Direct Service Professional explained the purpose of the visit. Shortly after, Administrator Ria Tabucal and Licensee, Glorie Pascasio arrived and assisted LPA with the inspection. The facility is licensed to care for four (4) Developmentally Disabled Adults, ages 18 through 59, ambulatory only.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. There is a visitor sign-in station located near the front door. The facility has an updated Infection Control Plan in place. Staff are adhering to infection control requirements.

Operational Requirements: The fire clearance is in place. The facility has a valid Liability Insurance policy in place. The facility has a valid Surety Bond in place. Fire Drill was last conducted on 09/14/2025. The Earthquake/Disaster drill was conducted on 09/15/2025 Clients PNI records reviewed, no discrepancies noted.

Physical Plant/Environment Safety: The facility is a single-story home located in a residential neighborhood, containing four (4) client bedrooms, two (2) full bathrooms, living room, kitchen, dining area, backyard, and attached garage. Currently, there are four (4) clients living in the facility. The interior and exterior physical plant was inspected. Client bedrooms were toured. Each bedroom has a smoke detector, bed, linen, dresser, nightstand, light, chair and sufficient closet space. Beds and furnishings are in good working condition.