Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit to conduct the annual required visit. LPA was greeted and granted entry into the facility and explained the reason for the visit. Facility is licensed for 4 ambulatory clients. The facility currently has 3 clients. Ricky Exconde has an Administrator Certificate expiring on 03/23/2026. Upon entry, facility appears clean, safe and sanitary.

LPA Lyman along with Assistant Administrator Leslie Exconde toured the facility at 7:50 AM. LPA toured the physical plant, checked food service, and reviewed facility documentation. The home consists of four client bedrooms, one shared hall restroom, client restroom, staff office/ staff restroom, living room, dining room, and kitchen. Client bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Client bathrooms were checked. Toilets and water faucets worked properly, and shower was free of mold or mildew. Water temperature measured between 105.6 and 106.5 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, doorways were free of obstructions. First aid kit had all the required elements including thermometer, tweezers and scissors. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Smoke detectors and Carbon Monoxide detectors tested operational during today's visit. Fire extinguisher is fully charged. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and yard is clean and shaded. Exit gate is unlocked, self latching and operational. LPA observed ample emergency food as well as emergency packs for clients. LPA reviewed the emergency disaster plan as well as infection control plan during the visit. Plans are thorough and complete. Facility provided documentation of last fire drill conducted on 07/05/2025 and drills are conducted quarterly. CONTINUED ON LIC 809C DATED 07/30/2025