Facility Evaluation Report

On today's date, Licensing Program Analyst (LPA) Rosie Quiroz conducted an unannounced Annual Required-1 year inspection visit. LPA was granted entry by Lead Direct Support Professional (DSP) Crystal Rios. Administrator (AD) Nolette Untalan arrived during today's visit.

AD Untalan indicated being present at the facility premises more than 20 hours per week AD Certificate for Nolette Untalan expires on June 20, 2025.

This is a leveI 4I Facility licensed for a capacity of four (4) clients of which two (2) clients may be non-ambulatory and providing services to Adult clients with Developmental Disabilities ages 18-59. At 9:05am, LPA Quiroz reviewed whether the following is in compliance: licensee is operating the facility within the conditions and limitations, which are specified on the license, including the capacity limitation.

At 9:15am, LPA along with (DSP) Rios conducted the tour inspection. A tour of the interior and exterior of the facility and physical plant were inspected, including but not limited to testing hot water temperature in client bedrooms and common bathrooms. Three of four client bathrooms water tested and measured between 87.0- 89.2 degrees Fahrenheit.(SEE LIC 809-D) All smoke detectors, carbon monoxide, were operational and functional. On or about 9:20am, while LPA Quiroz along with DSP Rios conducted tour of the kitchen area, LPA Quiroz observed loose kitchen cabinet next to the refrigerator and paint peeling from multiple kitchen cabinets. AD Untalan indicated facility is pending renovation of painting and cabinets, scheduled for this month. Furnishing cleanliness and state of repair, and fixtures were examined. AD Untalan agreed to purchase lamps and have maintenance come out today and repair kitchen cabinets and painting as needed. Maintenance arrived to facility on or about 11:40am(See LIC 90102-Technical Violation)

The facility is a 1 story apartment. The facility consists of: 4 client private bedrooms, 4 private restrooms for clients, visitors and staff, receiving area, living room, kitchen with dining area, laundry room area, facility carport,two small patios, one shaded backyard area with table and chairs for client and visitor enjoyment.