Facility Evaluation Report

Licensing Program Analyst (LPA) Celine De Perio conducted an unannounced required annual inspection focusing primarily on the Infection Control. LPA De Perio arrived to facility at 12:50 PM, and contacted facility administrator (AD) Joshua Estrevillo about visit due to observing no one present at facility and no response received upon ringing the doorbell at facility entrance. Both facility administrators Joshua Estrevillo and Trish Estrevillo arrived at facility at 1:15 PM. During the visit, LPA De Perio observed and verified that there were no staff and no clients present at facility.

The PUB475 "See Something, Say Something" poster was observed in the staff office and in each bedroom. LPA De Perio observed the Administrator's Certificate for Joshua Estrevillo, which expires on 10/1/22 and Trish Estrevillo which expires on 10/1/22.

LPA De Perio toured the interior and exterior portions of the facility with ADs Estrevillo. The facility is a single level structure and is licensed for four adult clients, of which 2 may be non-ambulatory. Currently, there are a total of 0 clients in care. There are a total of 4 single bedrooms. All bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. LPA De Perio toured each room and verified that there are no clients currently living at the facility, and observed no client belongings present.

Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. The restrooms were observed to be in good repair, toilets were operational. Water temperature in restrooms were measured to be at 105.2 degrees Fahrenheit.