Facility Evaluation Report

Licensing Program Analyst (LPA) Samer Haddadin conducted an unannounced annual visit to the facility. The facility is licensed as an Adult Residential Facility for Persons with Special Health Needs (ARFPSHN), with a licensed capacity of four non-ambulatory clients, all of whom may be bedridden. Upon arrival, LPA met with Licensee Ray Libang, was granted entry, and explained the purpose of the visit. LPA requested and reviewed the client roster and LIC 500 and also reviewed the facility file prior to the visit. At the time of the visit, there were four clients in care. LPA reviewed whether the facility was operating within the conditions and limitations specified on the license, including capacity limitations. LPA conducted a tour of the interior and exterior of the facility. All indoor and outdoor passageways, as well as other areas of potential hazard or obstruction, were inspected. All client bedrooms were inspected. All lift tracking devices in the clients’ bedrooms and bathrooms were inspected and found to be operational. Clients’ personal hygiene supplies were inspected and found to be available. No bodies of water were observed on the premises. Wired smoke detectors and carbon monoxide detectors were tested and found to be operational. Per the administrator, the generator is manually tested every Monday. LPA reviewed the facility fire drill log and observed that the last fire drill was conducted on February 7, 2026. Two fully charged fire extinguishers were observed and inspected. All toxins and disinfectants were inspected and found to be locked. The facility had the required two-day supply of perishable food and seven-day supply of nonperishable food. G-tube feeding supplies were also available, including a two-day supply, a seven-day supply, and emergency supplies. LPA observed that all medications were properly labeled, maintained as required, and stored inaccessible to clients in locked drawers. Hot water temperature was measured at 109.2 degrees Fahrenheit, and the room temperature was recorded at 75 degrees Fahrenheit. LPA did not observe any cameras installed in the facility. Based on the observations made, no violations were observed per title 22. An Exit interview was conducted and a copy of this report was provided