Facility Evaluation Report

On 09/08/2025, Licensing Program Analyst (LPA) Janette Romero made an unannounced visit to the facility to conduct a required annual inspection. LPA was greeted and granted entry by House Manager (HM), Vinnie Cordova who was informed of the purpose of the visit. Licensee, Shane Selburn was also present during the visit. LPA was informed that all clients were out in the community attending day program. The facility has a fire clearance for six (6) ambulatory clients and serves adults ages 18 through 59.

LPA toured the facility and reviewed records. During the tour, LPA observed the facility is made up of a one (1) story home with six (6) client bedrooms, two (2) bathrooms, a living room, dining room and office/laundry room. All client bedrooms had the required bedding, furniture, and lighting. Bathrooms had nonskid mats in the showers. Indoor and outdoor pathways were free of obstructions. LPA toured the kitchen and observed the facility has a two-day supply of perishable foods and a seven-day supply of non-perishable foods, which are stored in a safe and healthful manner. LPA observed knives and sharp instruments secured in lock box inside a kitchen cabinet. Medications are secured in a locked cabinet stored in the office. LPA and HM Cordova reviewed the physical medications for two (2) clients and their Medication Administration Records and no discrepancies were discovered. Cleaning solutions and disinfectants are secured in a locked laundry room cabinet. Licensee tested one (1) of the smoke alarms/carbon monoxide detectors and LPA observed it to be operational. LPA also observed charged fire extinguishers mounted throughout the facility. LPA reviewed the facility's Fire and Training Earthquake Log which noted their last fire drill was conducted on 09/04/2025. LPA reviewed the Record of Client's/Resident's Safeguarded Cash Resources (LIC 405) and Licensee Selburn, HMs Cordova and Anthony Zizzolopez reviewed the physical monies for all the clients, and no discrepancies were discovered. Emergency contact information, exit signs, client's personal rights, and complaint information are visibly posted near the front entrance. During today's visit, LPA did not observe any issues or concerns. An exit interview was conducted and a copy of this report was reviewed and provided to Licensee Selburn.