Facility Evaluation Report

At approximately 09:35 AM, Licensing Program Analyst (LPA) Star Stevenson arrived unannounced to conduct a Case Management visit related to an SOC341 received by the Department on 07/29/2026, as well as an Special Incident Report Received by the Department on 07/30/2026 from the facility.

LPA was greeted by Lead Caregiver Joanne Sigua who has Designation of Facility Responsibility (RP). Administrator Janne Angeles was called to advised of today's Case Management visit and Admin arrived at approximately 10:00 AM to further assist with today's Case Management visit.

LPA and Administrator discussed an incident that occurred with client (C1) on 07/28/2026 at approximately 12:30 PM

C1 was noted to have a dedicated staff member with them during today's unannounced Case Management visit.

LPA obtained documents, reviewed staffing ratios and conducted an interview.

A discussion was had about the requirements that C1 be provided constant supervision both inside the facility, as well as, outside the facility per the outlines set by the Individual Program Plan for C1.

Signature of Administrator denotes receipt.