Facility Evaluation Report

License Program Analysts (LPA) Luis De Leon conducted an unannounced annual required visit to Cullen Home . LPAs met with house manager Minerva Cobilla. The purpose of today’s visit was explained to facility personnel met during this visit. Later during the visit, Administrator Josephine Cochongco and Michelle Puno co-administrator arrived at facility. Facility is licensed to serve six (6) developmentally disabled adults ages 18 thru 59 years, ambulatory only.

The LPAs use the Compliance & Regulatory Enforcement Tool (CARE) during today’s inspection. The visit consisted as follows:

· Client Admission Agreements, Client & Staff files, Staff fingerprint clearance, Medications, Staff First Aid Certificate, Consumer IPPs.

· Three (3) client bedrooms and one (1) staff bedroom inaccessible to clients, two (2) bathrooms (only 1 used for clients), detached car garage, shaded outdoor area, living room, kitchen and dining room, and front and back yard.

LPA reviewed three (3) staff files and four (4) client files. Interview was conducted with (1) staff. Clients were not available at time of visit since attending to program activities outside facility.