Facility Evaluation Report

On 12/11/2025 at approximately 09:25AM, Licensing Program Analyst (LPA) Ali Deniz arrived unannounced to conduct a Required 1 Year visit and met with Staff Member, Sandra Martinez. Administrator, Thelma Adona, arrived during visit at approximately 9:50AM. Facility is an Adult Residential Home that provides care and assistance for Adults with Disabilities. Facility has an approved fire clearance for 6 ambulatory, of which 2 can be non-ambulatory, and a total capacity for 6 Clients. Upon arrival, LPAs was informed that there were 3 clients in care, and 1 staff member on-site. Facility is a 1-story building 3 client rooms, 1 staffroom, 2 bathrooms, and common spaces.

At approximately 10:15AM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation.

At approximately 10:45AM, LPA and Licensee toured the building and grounds which was found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed. All notices that are required to be posted have been posted and are in a highly visible area. LPA observed activity supplies for resident use. The amount of fresh and nonperishable foods is within regulation. Facility kitchen, refrigerators and freezers were clean, and food was stored properly. Staff were in the process of cleaning up kitchen at the time of this inspection. Toxins are stored in a locked housekeeping closet in the garage. Water temperature measured 107.6 degrees F and 112.4 degrees F which is within regulation between 105- and 120-degrees F at faucets accessible to residents. Fire Extinguishers found to be last charged on 07/10/2025 at the time of visit. Carbon Monoxide and smoke detectors were present and in order. There was enough lighting in all common areas, resident rooms, and hallways. Medication is centrally stored and secure in a kitchen cabinet.