Facility Evaluation Report

At approximately 9:05AM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a Required 1 Year visit and met with Staff Member, Romulo Damasco. Administrator/Licensee, Ferdinand Alfonso, was available by telephone. Facility is an Adult Residential Home that provides care and assistance for Adults with Disabilities. Facility has an approved fire clearance and capacity for 4 ambulatory clients. Upon arrival, LPA was informed that there were 4 clients in care, with 2 clients out of the community and one staff member on-site.

LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. LPA conducted a walk-though of the facility and observed the following: The facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Facility had emergency lighting. Facility is a one story building with 4 Client bedrooms, 1 staff room, 2 bathrooms, and common areas. Facility has an Infection Control plan on file. Toxins were observed to be stored inaccessible to clients. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for clients. Mattress pads were in place or available for client use. Hot water temperatures for all sinks in facility were within Title 22 regulations of 105 to 120 degrees Fahrenheit. During walk-through, LPA observed that facility did not have sufficient supply of nonperishable foods as required by Title 22 Regulations (deficiency cited, Regulation 85076(d)(1)).

LPA reviewed staff and client files, client medications and P&I monies. All files were all found to be well organized, thorough and contained the required documentation. Staff files had current First Aid certification. P&I monies were documented, secure and not commingled. Medication was observed to be centrally stored and secure. Administrator's Certificate for Ferdinand Alfonso (7000212735) was current with an expiration date of 06/02/2025. Fire extinguishers were last inspected October 2024. Smoke detectors and carbon monoxide detectors were tested and operational. Facility's last emergency drill was conducted January 2025.