Facility Evaluation Report

At approximately 11:30 Licensing Program Analyst (LPA) Contreras arrived unannounced to conduct a required 1-year facility inspection. Administrator unable to attend visit but granted Lead Staff/House Manager Jay Miranda to sign today's visit. LPA reviewed LIC308 and confirmed Jay Miranda as facility designee (admin). Facility is an Adult Residential Home approved for 4 clients which 2 can be ambulatory and 2 non-ambulatory. Facility is a one-story 5 bedroom home with 2 rooms vacant, one office/staff room and 2 rooms in use by clients. One client was attending day program and other client at an outing during visit. Facility had first client move in August 18, 2025.

LPA toured the building and grounds which was found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed inside and outside perimeters of facility. All required postings were visible. All bedrooms were observed to have clean linens, night stand, chair and light. Facility kitchen, refrigerators and freezers were clean. Snacks accessible to clients. Expiration dates noted in food and toxins are inaccessible to clients. LPA observed at least 7-day supply of non-perishable food. A 2-day supply of perishable foods was observed to be lacking. Frozen meats, eggs and ham were observed. However, fresh vegetables and fruits not observed in refrigerator (Technical Violation given). Sharps and knives were locked and inaccessible to clients . Canned goods were observed. Emergency water observed. LPA advised admin to separate everyday canned goods from emergency canned goods.

Bathroom accessible to clients had bath bats and paper towels. Water temperature measured within regulation at faucets accessible to clients. Fire extinguishers were charged and inspected on 12/2024. Carbon and fire alarms were tested and operational.