Facility Evaluation Report

On 1/28/2026, Licensing Program Analyst (LPA), Jacqueline Shaw-Ross arrived unannounced to conduct a required annual inspection. LPA was greeted and granted entry by Caregiver, Sakhone Sengvilay who was informed of the purpose of the visit. Present at the facility were one (1) additional caregiver and one (1) resident. LPA was informed that three (3) other residents were currently at day program. Administrator, Robert Jazmin arrived shortly. The facility has a fire clearance for four (4) ambulatory clients and serves adults ages 18 through 59.

The facility is a one-story, four bedroom, two bathroom house. LPA toured the facility's interior and exterior with Caregiver Sengvilay. LPA observed the facility living/family room, dining room, attached garage, and kitchen. LPA observed bedrooms to be clean with adequately furnishings. LPA toured the kitchen and observed the facility has the required two-day supply of perishable foods, and seven day supply of non-perishable food items. Disinfectants and cleaning solutions are secured in a cabinet under the kitchen sink. LPA observed one camera mounted in the living/family room.

Hot water temperature tested at 116 degrees. Medications are secured in a file cabinet near the dining room. Indoor and outdoor passageways are free of obstruction. Outdoor shaded seating is available for clients in care and there were no bodies of water observed on the premises. Smoke alarms/carbon monoxide detectors were tested and LPA observed it to be operational. LPA also observed one charged fire extinguisher mounted in the facility that was last serviced on 08/20/2025. LPA reviewed the Record of Client's/Resident's Safeguarded Cash Resources (LIC 405) for all four (4) clients and no discrepancies were discovered. LPA toured the garage and observed an operable laundry washer and dryer.