Facility Evaluation Report

On today's date, Licensing Program Analyst (LPA) LPA Rosie Quiroz conducted an unannounced visit for the purpose of conducting a required annual inspection. LPA Quiroz was greeted and granted entry into the facility by Secretary Michelle Santos. Administrator Mariles Borja arrived shortly after. Facility indicated screening all incoming visitors prior to entering the facility. Facility is licensed to provide services to a capacity of (32) thirty two developmentally disabled clients Age range 18-59. (26) twenty six Ambulatory clients and (6) six Non Ambulatory clients. Administrator Mariles Borja has a current Administrator certificate with expiration date of April 3, 2023.

On or about 11:20 am, LPA Rosie Quiroz along with Secretary Michelle Santos and Administrator Mariles Borja began the tour of the inside and outside of the facility. There are (28) clients in care and there are no active COVID-19 cases in the facility. During today's facility inspection, LPA Quiroz observed residents relaxing and resting throughout the facility and in their own cottages. Facility consists of four cottages. Cottage one accommodates (12) clients, cottage two accommodates (4) clients, cottage three accommodates (10) clients and cottage 4 accommodates (6) clients. LPA Quiroz interacted and interviewed with clients during today's visit. Clients present during today's visit appeared to be clean and well taken care of.

LPA Quiroz observed a COVID-19 check in station in the entry of the facility; LPA Quiroz observed required department COVID-19 precautionary postings in the facility as well as hand washing signs throughout the facility. Facility temperature recorded to be 75 degrees Fahrenheit.

All restrooms observed to have a supply of soap, appeared to be clean and water temperatures were recorded to be within normal limits. Clients bedrooms in four of four cottages appeared to be clean. All bedrooms observed to have all required components. LPA Quiroz observed the emergency and disaster and evacuation plan. Facility has a supply of emergency food, water and PPE in storage room behind cottage one readily available for staff and clients. LPA Quiroz toured the outside of the facility and observed seating and shaded area for clients and visitors enjoyment in backyard area. Continued on next page...