Facility Evaluation Report

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. LPA Tea was greeted and granted entry into the facility by Administrator (AD) Elizabeth Maldonado. The facility is licensed for 6 ambulatory clients only. Currently there are three clients living here during today's visit.

LPA Tea reviewed three client files and two staff files. Client files and staff files contained all required documentation. The administrator certificate expires on March 19, 2027.

LPA Tea along with the administrator toured the facility. LPA toured the physical plant, checked food service, and the first aid kit. The facility is a two-story home with four client bedrooms, one staff room, and three bathrooms. The facility has a kitchen, family room, dining room, and living room with an attached garage. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms are operational. Client bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each client comfortably. Client bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, and shower was free of mold/mildew. Water temperature measured around 115.3 Fahrenheit degrees. 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 dressing, bandages, tweezers, thermometer, and scissors. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPA observed sharps and toxins to be secured and locked and inaccessible to clients in the staff room. Fire extinguishers are fully charged throughout the facility. The facility’s last fire drill was conducted on January 7, 2026. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there was

(Continuation of annual report on LIC809C)