Facility Evaluation Report

An Annual visit was conducted on the date above by Licensing Program Analyst (LPA) K. McClurg. LPA met with Administrator (Admin) Maria M. Perez; QA: Program Liaison & Quality Assurance Development (PLAD) Leah Martinez. LPA introduced self, provided business card, stated purpose of visit, & was allowed to proceed with visit

Facility has in ground pool surrounded by fencing appropriately secured & at required height. Gate locked. Pool is secure preventing client access without staff supervision. Staff maintain water safety certificates.

Living & dining sufficiently furnished with adequate lighting. Kitchen appeared to be sufficiently clean. Sufficiently equipped with service ware, cook ware, & utensils. Sufficient supply of food on the premises. Residents bedroom sufficiently furnished with adequate lighting. Bathrooms appear clean with no unpleasant odors. Fixtures fully functional. Hot water measured at 120 degrees F.

Hazardous items stored in garage secured & inaccessible. Outside area free of debris. Sufficient outdoor seating with chairs & table available. Interior & external passageways clear & free of obstruction. Supply of Personal Protective Equipment (PPEs) available on premises.

Date of last Emergency Disaster & Fire drill conducted on 9/10/25. Smoke & carbon monoxide detectors operational. Fire extinguisher service:1/29/25.

Medications secure, & organized. Centrally Stored Medication & Destruction Record maintained. Client files reviewed. Staff files reviewed.

Exit interview conducted with Admin & PLAD. Report provided.