Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Lyman is conducting this unannounced visit for the purpose of completing an annual required inspection. LPA was greeted and granted entry into the facility and explained the reason for the visit. Compliance Directors Sadaf Forouhar and Kristian Le and Residential Supervisor Spencer Walters arrived during the visit. Facility is licensed for six ambulatory clients and there are six clients currently admitted to the facility.

LPA Lyman along with Client Coordinator Farrah Kharazmi toured the facility at 8:38 AM. LPA toured the physical plant, checked food service, and reviewed facility documentation. Facility is a single story house with 3 bedrooms, 2 bathrooms, kitchen, dining room, living room, therapy room and a 2 car attached garage. Client bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each client comfortably. At 8:40 AM, LPA observed there are missing light bulbs in the dining room, the light in the entryway does not work and there is a light bulb out in a client bedroom. LPA observed there are beds blocking designated exits in two client bedrooms and a desk blocking the exit in a third client room. Two smoke detectors are inoperable and one has been removed from the ceiling. The smoke detector in the hallway is operational. Client bathrooms were checked. Toilets and water faucets worked properly, and shower was free of mold/mildew. Water temperature measured between 106.7 and 107.6 degrees F in facility restrooms. Client bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards. First aid kit had all the required elements including tweezers, scissors and thermometer as well as a first aid manual. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Facility chef prepares lunch and dinner and clients prepare their own breakfast. Fire extinguishers are fully charged. LPA toured the outside grounds and there is ample shaded seating for clients. CONT ON LIC 809C DATED 07/03/2026