Facility Evaluation Report

Licensing Program Analyst conducted an unannounced case management visit regarding the incident report received on 12/5/25 and also to address a concern that was raised by the San Andreas Regional Center (SARC) Service Coordinator (SC) on 11/13/25. LPA was met by designated administrator Ninfa Gozon (DADM) and stated the purpose of the visit.

The facility is licensed to serve adults age 18 through 59 who are developmentally challenge (level 4F/5), approved for 15 non-ambulatory, and 6 may be bedridden, all bedrooms are approved for bedridden.

LPA conducted a tour of the facility with DADM and observe residents were at the TV area waiting for their rides to get to the day program. LPA observed 2 two seater grey couches that were new and recently acquired. DADM stated they had to change the old couch because it was starting to fray and is no longer safe for residents to use. The new couches were ordered immediately and was delivered within a day.

LPA observed hallways were free from obstructions and staff were disinfecting and organizing after serving breakfast to 15 residents. LPA inspected 8 resident rooms, 7 shared rooms and 1 is a private room.

On 12/05/25, the Department received an incident report regarding a resident (R1) who eloped while at the Goodwill Store on 12/03/25, was missing for 15 minute and was hit by a car, ended up in the emergency room and sustained an abrasion the the left arm.