Facility Evaluation Report

Licensing Program Analyst (LPA) Jacqueline Shaw Ross made an unannounced visit to the facility to conduct an annual licensing inspection. LPA was met by Crystal Pablo, Caregiver, and was granted entry into the facility. LPA then met with Lead Staff, Rolando Javier and discussed the purpose of the visit.

A tour of the facility was conducted inside and out. LPA, accompanied by Mr. Javier, conducted a general overall inspection, which included but was not limited to the following: Facility physical plant, food service, medication management, record review and facility administration. The facility is licensed to serve six (6) Developmentally Disabled Adults, two (2) of whom may be non-ambulatory in bedroom #1 and #2 only.

The facility is a four (4) bedroom, three (3) bathroom two (2) story house. Three (3) bedrooms are private occupied and one (1) bedroom is shared, two (2) to a room.

During today's inspection, LPA observed the following: Indoor and outdoor passageways were observed to be free from obstruction. There are no pools or bodies of water. Per Mr. Javier, there are no firearms or other dangerous weapons in the facility. Poisons and cleaning agents were observed to be secured and inaccessible to residents in care. Facility fire clearance is maintained in conformity with State Fire Marshal regulations. LPA toured every room in the facility. Rooms designated as resident rooms had the required furnishings and sufficient lighting available. Facility provides each resident with clean linen, in good repair, and sufficient hygiene products for personal use. The hot water temperature measured at 107.2 degrees F. The facility had a functioning carbon monoxide detector, multiple smoke detectors, and multiple operable fire extinguishers. Emergency drills are conducted quarterly and the last drill was on 10/1/2023.