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 arrived at the facility at 12:45pm and rang the doorbell but no one answered. LPA called the Staff, Gregory Tillman, who said on arriving in a few minutes. At 1:05pm, LPA met with staff, Gregory Tillman and Ana Rodrigurez, DSP and explained the purpose of today's visit. The facility is approved to serve developmentally disabled clients ages 18 through 59 years, 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 maintained. Staff are adhering to infection control requirements. The facility has an Infection Control Plan in place.

Operational Requirements: The fire clearance is in place. The facility has a valid Liability Insurance policy in place. Surety Bond is valid. Last Fire Drill was conducted on 10/15/2025.

Physical Plant & Environment Safety: This facility is a single-story home consists of kitchen, dining room, living room, (4) client bedrooms, (2) bathrooms, den/activity area, laundry area, detached garage and a backyard. Client bedrooms were toured. Each bedroom has a smoke detector, bed, linen, dresser, light, chair and sufficient closet space. Bed and furnishings are in good working condition. Extra towels and linens are kept in the hallway closet. Smoke alarms and carbon monoxide were tested and operable. Laundry area is next to the kitchen. The fire extinguisher in the kitchen was recently inspected on 07/15/2025. Knives, cleaning solutions, and disinfectants are locked and inaccessible to clients. Fireplace is closed and inaccessible to clients.