Facility Evaluation Report

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Required-1 year visit. LPA met with Felimon Abcede, DSP II and explained the purpose of the visit. The facility is licensed to serve (4) developmentally disabled adult age range 18 through 59, (4) ambulatory of which (1) may be non-ambulatory, bedroom #3 cleared for non ambulatory. At 1:15pm, administrator Stephanie Baynosa arrived and assisted LPA. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: The required cleaning and disinfection activities are performed. Infection control practices and Personal Protective Equipment (PPEs) were maintained. Staff are adhering to infection control requirements.

Physical Plant & Environment Safety: This facility is a single story home consists of (4) client bedrooms, (2) bathrooms , living room, kitchen, dining area, attached garage and backyard. There are (2) clients residing in the home, one of which is non ambulatory. Client bedrooms were toured and have sufficient storage space and lighting. Night light is maintained in hallways and passages to non private bathrooms. Knives, cleaning solutions and disinfectants are locked and inaccessible to clients. Cleaning supplies are locked in the garage storage cabinet. Combo smoke detectors and carbon monoxide detectors were tested and operable. No security window bars installed. Laundry area is in the garage. Facility has working telephone service. Water temperature readings are within the required 105 - 120 degrees Fahrenheit. Indoor passageways were kept free of any obstruction and there are no pools or large bodies of water. Backyard was inspected and has a sitting area with outdoor furniture. There is a locked shed in the side yard to store garden supplies/equipment.

Operational Requirements: Staff provide necessary personal assistance and care based on the clients' needs and services plan. The fire extinguisher mounted on the kitchen wall was serviced on April 7, 2026. Surety bond insurance is valid in the amount of $1000 and expires on 12/23/2028 . The outdoor activity area in the backyard provides a shaded area and furnished for outdoor use.

*****Refer to LIC 809C for the continuation of this report.*****