Facility Evaluation Report

Licensing Program Analyst (LPA) Jerome Haley conducted an unannounced visit for the purpose of conducting a required one-year annual inspection. LPA was greeted, granted entry by staff and explained the reason for the visit. Administrators (AD) Leilani Dagdag was notified and arrived a few minutes later and was present for the remainder of the visit.

Structure: The facility is a single level structure and licensed for five ambulatory clients. As of today, facility had four clients, two clients were present during the visit and the other two clients were at their day program. There’s a total of 5 bedrooms for the clients, with one room is currently vacant, and two restrooms. There’s a living room space and a dining space. Bedrooms: All bedrooms have the required furnishings: bed, lamp, chair, and storage space. Bathroom(s): Bathrooms are equipped with a working toilet, wash basin, and shower. Non-skid mats were observed. Hot water measured in between 105 – 105.9 degrees F. Kitchen: 2 of 4 burners were operational on the gas stove. AD Dagdag showed me a receipt for a new stove that’s scheduled to arrive July 23, 2025. Sharps are kept locked in a locked cabinet below the counter near the sink. No cleaning chemicals are stored in the kitchen. Below the sink is a supply of pots and pans. Food Service: LPA Haley observed a supply of perishable and non-perishable food items that meet regulation requirements. Nonperishable food items are stored in the pantry area closet right outside the kitchen in the hallway.

Client & Staff Files : Client and staff files are located in a locked closet in the hallway. The locked closet also contained the clients’ P&I funds.

File Review: 3 of 4 client files were reviewed during the visit, and three staff files were reviewed.