Facility Evaluation Report

On 11/24/25 Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to conduct a case management health and safety checks visit. LPA met with Licensee, Manuel Vasquez, who was informed of the purpose of the visit. At the time of the visit there are (1) staff and (0) clients present.

Below are the observations made during today's visit. The facility continues to have no clients are placed at the home at this time. The was facility was observed to have operable utilities (gas, water, electric).

The facility food supply did not meet the requirements of a 2 day supply of perishable and a 7 day supply of non-perishable food items, however there are no clients in care. Per discussion and guidance provided Licensee Vasquez understands to be prepared to have a sufficient food supply, as soon as he is made aware of any potential placement's. LPA provided Mr. Vasqzuez with a copy of the LIC200-application as there is a need to update the facility mailing address. The information was completed during today's visit and the facility information will be updated accordingly.

An exit interview was conducted and a copy of the report was reviewed and provided to Licensee Manuel Vasquez.