Facility Evaluation Report

Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year visit. The purpose of the visit was explained to DSP staff Eleanor Lopez. Assistant Administrator Jasmin Tomines arrived shortly after. The facility is licensed as a level 4i Adult Residential Facility serving developmentally disabled residents 18-59 years.

Infection Control: The Infection Control Plan includes Environmental cleaning and disinfection activities. Facility has sufficient Personal Protective Equipment.

Physical Plant/Environment Safety: The facility is a single story home located in a residential neighborhood that is licensed for four (4) ambulatory clients. It consists of 3 client bedrooms, living room/dining room, kitchen, 2 bathrooms, backyard patio area, and attached garage. Exit doors are free of any obstruction and there are no pools or large bodies of water. Smoke and carbon monoxide detectors were tested and are operational. The facility one (1) fire extinguisher. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. The facility has a 1st Aid Kit and Manual. Cleaning supplies, knives, and toxic substances are inaccessible to residents.

Operational Requirements: Fire clearance is approved for four (4) ambulatory residents. Care and supervision to meet the clients needs was observed. Special equipment and supplies are used by residents. The Surety Bond is current with expiration date of 10/4/2026.

Staffing: A total of 7 staff members provide care and supervision to the clients.