Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with House Manager (HM) Oliver Antipala. LPA observed 3 staff and 3 residents in the facility, and 3 residents went out to the day program. LPA reviewed 3 resident files and 3 staff files.

LPA toured the facility inside and out with HM. License, Personal Rights posters and Administrator Certificate were observed posted at facility. Living room, family room, kitchen, dinning room and two restrooms were inspected. Three shared resident bedrooms, two restrooms, and garage were inspected. One staff live-in room was observed in facility. First Aid Kit, flash lights, and night lights were observed in the facility. Skid resistant floors were observed in the restroom.

Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. Medication closet, knives closet, and cleaning product closet were observed locked. Room temperature was at 72 degree F, and hot water temperature was at 108 degree F in facility.

Fire extinguisher was serviced on 6/25/2025. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. carbon monoxide detectors were tested by HM, and were working fine. Front yard and backyard were inspected. There was no obstruction to block the walkways. All the bed rooms were observed with screens. The last time the facility conducted the emergency drill was 3/19/2026.

No citation noted for today. Exit interview was conducted with HM. This report was provided to HM for signature. A copy of report was provided to HM.