Facility Evaluation Report

Licensing Program Analyst (LPA) Iby Strong conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Direct Support Professional (DSP) Nelia Tiongco. Administrator Daniela Borisova and Milen Borisov arrived shortly after. According to the facility’s license, the facility has a maximum capacity of four (4) clients of whom all must be ambulatory.

LPA toured the interior and exterior of the facility and inspected each room. This is a two story home. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. Cooking/dining equipment and utensils were present. Medications were labeled, as required, and stored in locked areas. Water temperature was measured at 114 degrees F.

No pool or body of water present. Per Administrator no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher were present. First aid kit were complete and readily accessible.

Client records reviewed contained the required documentation. Staff records reviewed contained required documentation. There were no sharp objects or toxic chemicals accessible to clients.

No deficiencies were cited or observed on today's visit.

An exit interview was conducted with Administrator to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.