Facility Evaluation Report

On October 14, 2025, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry into the facility by staff after explaining the purpose for the visit. Administrator (AD) Normando Surio was present and assisted on today's inspection. LPA observed that Normando Surio has a valid Administrator certificate which expires on March 25, 2027.

The facility is an Adult Residential Facility (ARF) licensed for six clients, of which one may be non- ambulatory. The facility is a single story home with four private clients bedrooms, three staff bedrooms, seven bathrooms, a living room, a dining room, a kitchen, a laundry room, and an attached two car garage. LPA, accompanied by the AD, conducted a tour of the interior portions of the facility. On today's visit, there are four clients in care and there are five staff present. LPA observed clients participating in various activities such as exercise and puzzles. LPA inspected the four private client bedrooms and observed them to be free of any hazards. LPA observed client bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed clients beds to have clean linens. LPA observed additional linens to be stored in a hallway closet. LPA inspected all client bathrooms and observed them to be free of any hazards. Bathrooms were equipped with grab bars and nonskid floor mats. Faucets and toilets were operational. Hot water temperature measured between 110.3 and 110.8 degrees Fahrenheit. LPA inspected the three staff bedrooms and observed them to be free of any hazards.

LPA observed the facility has a two day perishable and a seven day nonperishable food supply on hand in the kitchen. LPA observed kitchen appliances to be clean and operational. The five burner gas stove lights unassisted. LPA observed kitchen knives and sharps to be stored in a locked kitchen cabinet. CONTINUED ON LIC809-C