Facility Evaluation Report

On 01/21/2026 at approximately 09:30AM, Licensing Program Analyst (LPA) Ali Deniz arrived unannounced to conduct 1-Year Required visit of this licensed Adult Residential Care Facility (ARF). LPA was greeted by Administrator, Nestor Balauro. Facility has an approved fire clearance and capacity for 4 non-ambulatory clients and has an approved hospice waiver for 1 individual. Upon arrival, LPA was informed that there were 4 clients in care and 4 staff member on-site. Facility is a 1 story building with 4 client bedrooms, 3 bathrooms, and common spaces.

At approximately 10:05 AM, 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 10:15AM, LPA and administrator 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. LPA observed activity supplies for clients’ use. The amount of fresh and nonperishable foods is within regulation. Facility kitchen, refrigerators and freezers were clean, and food was stored properly. Toxins are stored in a locked kitchen cabinets under the sink and cabinets in the garage. Water temperature measured 112.6 degrees F and 117.4 which is within regulation between 105- and 120-degrees F at faucets accessible to residents. Fire extinguishers were bought new on 07/24/2025. Carbon Monoxide detectors were present and in order. There was enough lighting in all common areas, resident rooms, and hallways. Medication is centrally stored and secure.

At approximately 11:10AM, LPA reviewed 4 client records and found 4 of 4 clients did have current physician's reports, care plans, signed admission agreements, and physician's orders on file. Medication records are thorough and contained physician's orders for each client.