Facility Evaluation Report

Licensing Program Analyst (LPA) Maria (Mita) Partoza conducted an unannounced required 1 year inspection visit and met with designated administrator (DADM) Jhanelle Guico and stated the purpose of the visit. Administrator Malou Sedigh, was not present at the time of the visit. DADM stated that ADM was not available due to prior commitment.

The facility is licensed to serve adults 18 to 59 all may be non-ambulatory and developmentally disabled. LPA observed 4 Out of 5 residents (R1 to R5) and 4 staff were present at the facility. 1 Out of 5 resident was inside the room with 1 staff, 2 out of 5 was watching TV with 1 staff, 2 out of 5 was with 1 staff outside playing catch ball. 1 Out of 5 is with family.

At 9:00 a.m. LPA toured the facility inside and outside with DADM including but not limited to the kitchen, bathroom, dining room, living room, 5 residents rooms, garage, backyard and exterior perimeter. The temperature inside the home was at 72 degrees Fahrenheit.

The kitchen was observed to be sanitary and organized, knives and sharps were locked and not accessible to residents. LPA observed 2 days of perishable food and 7 days of non-perishable food. The kitchen water temperature measured at 112.6 degrees Fahrenheit. LPA observed the drawers in the dining room was not closing properly, the cabinet kitchen door left side of the stove came off the hinge.

The bathroom are equipped with grab bars and non-skid mats. The water temperature in the bathroom measured at 112.4 degrees Fahrenheit. Resident's room have sufficient storage. LPA observed Room 5 has a broken armoire the drawers cannot be easily opened. Each room has emergency exit doors that access the backyard. LPA observed an alarm for each door that requires the batteries to be replaced. DADM stated that the facility has a night staff that watches over the residents.