Facility Evaluation Report

Licensing Program Analysts (LPA)’s Janira Arreola and Abdoulaye Zerbo, conducted an unannounced visit to the facility to conduct a Case Management Visit. The purpose of this report is to document the deficiencies observed during the visit. LPAs met with Staff, Bonifacio Carlos who was informed of the purpose of the visit. The Licensee was not available over phone at the time of the visit. LPAs conducted a walk through, conducted interviews and records review.

During today's visit LPAs toured the home and conducted a health and saftey check on the facility and clients. No immediate issues were observed.

LPAs observed the facility yard has a gated and locked pool with green opaque water half way full. This was cited and a plan of correction was created.

An deficiency was discovered during file review of the facility. The facility has an outstanding fee balance for $681.00 that was due 06/14/2024.The licensee stated they would pay the outstanding the balance. Therefore the facility is being cited for not paying their annual licensing fees.

An exit interview was conducted where this report along with the LIC809D page, and appeal rights were reviewed and provided.