Facility Evaluation Report

Licensing Program Analyst (LPA) Samer Haddadin conducted an unannounced Required 1-Year Annual Visit using the CARE Inspection Tool on [insert date]. Upon arrival at the facility, LPA met with Direct Support Professional (DSP) Daysi Toscano and explained the purpose of the visit.

The facility is licensed to operate for six (6) ambulatory clients. It is a single-story residence located in a residential neighborhood. The layout includes three client bedrooms, one staff bedroom, one activity room, two bathrooms, two living areas, a dining area, a kitchen, a swimming pool, an attached garage, and a covered outdoor patio area.

At the time of the visit, there were three clients in placement, all of whom were attending their day program.

LPA conducted a tour of the indoor and outdoor areas of the facility with DSP Toscano. There were no obstructions on the premises. The swimming pool was properly secured and locked by two gate doors, each five feet in height, located at different entrances. Both gates opened away from the pool, in compliance with safety standards.

All beds and bedding supplies were in good condition. Adequate lighting was observed throughout the facility, and clients had appropriate storage for personal belongings. The facility was adequately stocked with bed linens, comforters, and bath towels. All client bedrooms and the staff bedroom were inspected.

Bathrooms were clean and operational; however, the hot water temperature was measured at 134.2°F, which exceeds the allowable range under Title 22 regulations, constituting a violation.