Facility Evaluation Report

On 07/03/24, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced annual visit to the facility listed above. LPA met with Staff, Calvin Fortune, and the purpose of today was explained. We were joined by Program Director, Hai Nguyen, and Administrator, Suyono ‘John’ Wong. The facility is licensed to serve five (5) ambulatory clients ages 18 through 59. Currently the facility has four (4) clients that were at day program during the time of visit.

Physical Plant/Structure The facility is a single-story home in a residential neighborhood. It consists of four (4) bedrooms, two (2) bathrooms, two (2) living areas, dining room, kitchen, attached garage, and an outside shaded patio. LPA observed the patio had a table and chairs available for client use. LPA observed all walkways around the home to be clean, clear, and free of debris, hazards, and obstructions. LPA did not observe any bodies of water on the premises.

Bedrooms LPA inspected all rooms and found them to be clean and in good repair. LPA observed the rooms have the required furniture including a bed, dresser, nightstand, chair, and storage space for personal belongings. LPA observed the beds have the required linens including a mattress cover, fitted sheets, blanket, comforter, and pillows. LPA observed an additional supply of linens stored in a