Facility Evaluation Report

On 7/28/2026 at approximately 10:00 AM, Licensing Program Analyst (LPA), Angelica Segovia conducted an unannounced annual visit to the facility. LPA was greeted by staff and stated the reason for their visit. The Administrator, Jermarcus Dumas arrived shortly after to assist with today’s visit.

LPA asked for the census and Staff/Client Roster. LPA conducted a physical plant tour at approximately 12:00 PM and the following was noted:

The facility is a single unit building with five (5) bedrooms and three (3) bathrooms currently occupying four (4) clients. There is one (1) designated staff room, with its own private bathroom. The facility has an approved fire clearance for six (6) ambulatory clients. The facility is vendor through North Los Angeles Regional Center (NLARC) and is being operated at a Level IV Adult Residential Home. Sign in sheets, hand sanitizers, gloves and masks are available immediately upon entrance.

Common areas: The living rooms and dining rooms were observed to be neat, clean, and organized. The rooms were observed to be properly furnished and in good repair. The facility maintains a comfortable temperature at 74°F. LPA observed a fire extinguisher to be located in the hallway and dated 04/06/2026. LPA observed required postings such as See/Say Something and Rights of Individuals with Developmental Disabilities located alongside the entrance. A fireplace was observed to be covered and inaccessible to clients. A working telephone was observed.

Kitchen: The kitchen was observed to be clean and free from pests. Sufficient supplies of seven (7) day nonperishable foods and two (2) day perishable foods were observed. The knives/sharps were observed to be kept in a locked kitchen cabinet within a locked utility box and inaccessible to clients. Kitchen appliances were observed to be working and in proper condition. LPA observed an additional freezer located in the backyard equipped with additional food. (continued on LIC 809-C)