Facility Evaluation Report

On 05/23/2024 at 8:01 a.m. Licensing Program Analyst (LPA) Maria (Mita) Partoza arrived and conducted an unannounced required 1 year inspection visit. LPA was greeted by 2 staff and the administrator (ADM) Sandy Zipagan. LPA stated the purpose of the visit to ADM.

The facility is a Adult Residential Facility (ARF) licensed to serve (6) developmentally disabled adults 18-59 years old. All of whom can be non-ambulatory and the facility is approved for 2 hospice waiver for residents. 2 staff were present at the time of the visit. 6 out 6 residents was getting ready to go to the day program at the time of the visit.

At 8:10 a.m. LPA toured the facility inside and outside with ADM, including but not limited to the kitchen, bathroom, dining room, living room, residents rooms, backyard, garage and walkways. The temperature inside the home was at 68 to 69.8 degrees F.

LPA and ADM toured the 4 rooms, 3 out of 4 rooms are used by residents and 1 out of 4 rooms are used as a staff room. LPA observed 2 bathroom 1 out of 2 is currently under repair. LPA inspected the permitted Additional Dwelling Unit (ADU) at the back of the house. ADM stated the ADU will be used as staff dwelling no resident will be housed in the ADU. The ADU has full kitchen, bathroom, laundry area, living area, 1 bedroom and closet. LPA observed 3 out of 3 resident rooms are shared. LPA observed rooms to be organized, sanitary and free from any debris and has sufficient storage for residents' personal belongings. LPA observed that 3 out 3 bedroom has sliding door that easily opens and are free from obstruction.

LPA observed that the facility has smoke and carbon monoxide alarm that are in good working condition. LPA observed hallways, ramps and walkways are free from obstruction. LPA observed the backyard area to be free from debris and is well maintained.