Facility Evaluation Report

On 1/21/2026, Licensing Program Analyst (LPA) Perchui Milena Khurshudyan arrived at this facility to conduct a required Annual Inspection. Upon arrival LPA was greeted by the DSP/Caregiver Emerito Paino, who granted access to the facility. LPA introduced herself by showing her department badge and explained the reason for the visit. The facility Administrator was contacted by phone and arrived shortly after. LPA Khurshudyan reviewed the required postings on a wall throughout the facility. The inspection tool was used to complete today's visit.

At 1:05pm LPA, with the help of the DSP/caregiver, began a physical plant tour of the facility and the following was observed: This is a single-story building with four (4) bedrooms, two (2) bathrooms, kitchen, garage, common areas, and outdoor areas. This facility is an Adult Residential Facility (ARF). A fire clearance was approved for four (4) Ambulatory, of which one (1) resident can be Non-ambulatory and reside in master bedroom only. Facility is operating level 3 clients. The smoke alarms and carbon monoxide detectors are hard wired and inter-connected; they were tested and are operational. The facility has two (2) fire extinguishers that were last service on 1/12/2026: the first one is located by the entrance, on the wall, and the second one is located in the kitchen.

Kitchen: LPA observed a seven-day supply of non-perishable food, and a two-day supply of perishable food properly stored and labeled. No expired food was observed. Facility stores knives and sharps under the sink inside the locked cabinet. An emergency supply of food / water was stored inside the kitchen cabinets and pantry. Food storage and preparation areas are clean and inaccessible to pests. A weekly menu was also available for clients.