Facility Evaluation Report

Licensing Program Analyst (LPA) Lydia Martinez conducted an unannounced Required - 1 year evaluation. LPA Martinez met and was granted entry by Staff Leo Gutoman. Lead Staff Policarpio "Paul" Veliz was called to assist with the visit. Administrator (AD) Laura Rubio was notified via telephone but unable to meet with LPA. AD Rubio has an Administrator Certificate which expired on 12/23/2022. LPA spoke to AD Rubio via telephone, who stated she has a Designated Administrator Dominic Lombos and will submit documents soon. Designated Administrator Lombos arrived shortly after. Administrator Rubio arrived shortly after.

LPA Martinez reviewed whether facility is operating within capacity limitations. Lead Staff Veliz reported census is 3, 1 was present and the other 2 clients were at Program but arrived during LPA's visit.

Facility is a LeveI 4I, licensed for a capacity of 6. The facility is a 2 story home that consist of 3 shared client bedrooms (currently private), 2 staff rooms (1 upstairs), 3 bathrooms, living-room, kitchen with dining area, Office, Meeting Room and a 2 car garage that is used for storage and laundry. The backyard has a covered patio with table and chairs for clients and visitors. Washer and dryer observed to be functional and operational. LPA, along with Lead Staff Veliz conducted a tour of the inside and outside of the facility; all passageways and other areas of potential hazard were inspected. Client bedrooms were observed to be spacious and easily accommodate furnishings such as lamps, chair, dresser and a bed. One client bathroom was clean. Faucets, showers and toilets were operational in all 3 bathrooms. LPA noted couple brown chairs are broken and were removed. LPA observed some hygiene items, but is in need of toothbrushes and toothpaste for the clients. The facility has a clean supply of linen and towels for each client. Hot water temperature in client bathroom was within regulatory requirements. All toxins, sharps and disinfectants were locked in a secured hallway closet. Kitchen and dining area were inspected. Food prep area is clean and organized. Food supply meets the requirement of one (1) week supply of non-perishable and two (2) day supply of perishables.