Facility Evaluation Report

Licensing Program Analyst (LPA) Maria (Mita) Partoza a conducted an unannounced required 1 year inspection visit. LPA was greeted by two staff (S1& S2) and called Designated Administrator Mark Arvin Agustin. On 10/8/25, LIC/ADM sent a notification to LPA and assigned Mark Arvin Agustin to be the designated administrator in his/her absence while LIC/ADM is out. LPA met with designated administrator (DADM) and stated the purpose of the visit.

The facility is licensed to serve 18 to 59 years old who are developmentally challenged. All may be non-ambulatory. A detached ADU at the rear of the facility is approved to be occupied by staff.

At 12:30 p.m. LPA toured the facility inside and outside with including but not limited to the kitchen, bathroom, dining room, living room, 3 residents rooms, 2 Staff room, activity area, laundry area, pantry, backyard and exterior walkways. LPA observed no obstruction on the walkways both inside and outside. The overall condition of the facility is organized and in good repair. Ramp for non-ambulatory are clear from obstruction and in good repair.

LPA observed the washer and dryer area was in good working condition, chemicals are separated from the food pantry. LPA observed that 3 Out of 3 resident bedroom have sufficient lighting, sufficient storage for resident's personal belongings. 2 Out 2 bathroom used by residents have grab bars and anti-skid floor. The facility has a dining area and a living area that are free from debris and organized. 4 Out of 4 residents arrived from the day program, accompanied by 3 staff.