Facility Evaluation Report

Licensing Program Analyst (LPA) Rankin conducted a required unannounced 1-year annual visit to the facility above on 03/3/2026 around 10:05 AM. LPA met with Administrator Josie Sarabia and explained the purpose of the visit.

A tour of the inside and outside of the facility was conducted. The following was inspected and noted during the annual visit:

Physical Plant & Environmental Safety : The facility has 4 client bedrooms and 2 client bathrooms currently occupying 4 clients. The facility is clean, safe, and sanitary. LPA was authorized to enter and inspect facility. The facility has smoke and carbon monoxide detectors, these alarms were tested and were working at time of visit. The lighting and lamps are sufficient for the use of the facility and for client comfort and safety. The showers have non-skid flooring and mats. Toilet, hand washing and bathing facilities are operational. The pathways are clear of any obstructions. Disinfectant, cleaning solutions and poisons are kept locked in the garage and washer room closet. The facility has sufficient space inside and outside for activities and visiting.

Operational Requirements: The facility has a current plan of operation on file with the department. The Facility is operating in compliance with the granted fire clearance.

Clients Records & Incident Reports: The facility keeps separate files on each client confidential. Four files were reviewed for signed Admission Agreements, Medical Assessments LIC. 602A Physicians Report, TB results, Emergency contact forms, and Appraisal Needs and Services plans (ANS) are done and completed. Facility does submit incident reports to the department when required. Continued on 809-C