Facility Evaluation Report

Licensing Program Analyst (LPA) Debbie Palacios made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Housekeeper, Edwin Nunez who was informed of the purpose of the visit; LPA spoke via telephone with Cheryl Balquiedra, Licensee to be allowed entry to the facility . Licensee Cheryl explained to LPA that the facility has not had clients since their pre-licensing visit due to Regional Center requesting pending documents. Cheryl reported the facility is currently waiting on Regional Center to approve them for placement. There was no clients in care and no approved staff in the facility. The facility has a fire clearance for four (4) ambulatory clients and serves adults ages 18 through 59 years of age.

LPA toured the facility and observed the facility is made up of one-story home with four (4) client bedrooms and one (1) staff bedroom; three (3) bathrooms, a living room, dining room, kitchen, and attached garage. The living room was observed to have board games and other activities. The facility was observed to be in a clean condition; All client bedrooms had the required furniture, lighting, and closet storage. LPA toured the facility's exterior and observed outdoor pathways were free of obstructions. LPA toured the kitchen and observed the facility has a two-day supply and perishable foods and more than a seven day supply of non-perishable foods that were observed to be properly stored and readily available in the pantry cabinet. LPA observed that the facility had a first aid kit located in the office cabinet Knives and sharp instruments were secured in a locked kitchen cabinet. Staff files reviewed had the Department's required training records and valid first aid/CPR certification and fingerprint clearances. The facility has one (1) fire extinguisher located in the kitchen mounted on the wall, service date is 05/09/24. Smoking alarms and Carbon Monoxide were working properly.

During today's visit, LPA did not observe any immediate violations or concerns. An exit interview was conducted, and a copy of this report was reviewed and provided.