Facility Evaluation Report

At approximately 9:35AM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a Required 1 Year visit and met with Administrator, Nestor Balauro. Facility is an Adult Residential Home that provides care and assistance for Adults with Disabilities. Facility has an approved fire clearance and capacity for 4 Non-Ambulatory Clients and have an approved hospice waiver for 1 individual. Upon arrival, LPA was informed that there were four clients in care with three clients out of the facility attending Day Program and five staff members on-site.

At approximately 9:50AM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. LPA conducted a walk-though of the facility with Administrator. LPA observed the following: The facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Facility had emergency lighting. Facility is a one story building with 4 Client bedrooms, 3 bathrooms, and common areas. Facility has an Infection Control plan on file. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Toxins and other hazardous items were observed to be stored inaccessible to clients. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for clients. Mattress pads were in place or available for client use. Hot water temperatures for all sinks in facility were within Title 22 regulations of 105 to 120 degrees Fahrenheit. Fire extinguishers were last inspected May 2024. Smoke detectors and carbon monoxide detectors were tested and operational. The last facility emergency disaster drill was conducted March 2025.

Administrator's Certificate for Nestor Balauro (7014652735) was current with an expiration date of 02/06/2026.

LPA unable to complete Annual Inspection Visit. Annual Continuation Visit to be conducted at a later date.

Exit interview conducted. Copy of report discussed and provided to Administrator. Signature on form confirms receipt of documents.