Facility Evaluation Report

Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced required Annual Inspection visit to the above-named facility. LPA met with Sandra Y. Lopez-Martinez, Administrator and explained the purpose of the visit. Tracy Jackson, Quality Assurance Lead Specialist, Tri-Counties Regional Center accompanied LPA on the visit.

The facility currently has four (4) residents residing in the facility. At the time of arrival, there was one resident in the facility and two staff on duty. Administrator Lopez-Martinez was present in the facility at the time of arrival.

LPA conducted a physical tour of the facility. The facility is a one-story home to residents with intellectual disabilities. The facility contracts with Tri-Counties Regional Center.

The facility has 2 private bedrooms, 1 shared bedroom, and 2 shared bathrooms for 4 residents and 2 live-in staff. Each bedroom has a bed, nightstand, and lights and nightstand lamps to provide sufficient lighting.

The front yard consists of concrete steps and concrete walkways. The backyard has a patio with outdoor furniture. The recycling bin, green waste bin, and trash bins are standard bins with flip lids. A locked shed is located at the back of the home.

LPA and QAS Specialist observed multiple items stacked and piled in various areas of the backyard and patio. Items include exercise equipment, washing machine, walkers, rugs, floor mats, wastebasket, plastic bag with shoes, wires, and gardening supplies.

LPA and Tri-Counties Regional QAS Specialist observed expired canned goods, an expired box of breakfast cereal, and an opened box of cake mix not properly packaged.

LPA and Tri-Counties Regional QAS Specialist observed items such as bags of clothing, purses, shoes, and other miscellaneous items stored in Resident 1’s (R1’s) room. Administrator Lopez-Martinez stated the items do not belong to R1.