Facility Evaluation Report

Licensing Program Analyst (LPA) Kelly Dulek conducted an unannounced Annual Inspection at the facility today. LPA arrived at 01:18PM and initially met with facility staff Arianna Esparza. Program Director Tiai Salanoa was contacted via telephone and arrived during facility tour. Entrance interview conducted.

A tour of the physical plant was conducted with the facility staff at 01:23PM and the following observed:

Fire extinguishers located throughout the facility were observed to be fully charged and last serviced on 07/07/2023. Smoke detectors and carbon monoxide detectors were tested at 03:50PM and were functional at the time of the visit. Sprinkler system was tested on 07/14/2023 and was functional at that time.

BEDROOMS: There are three (3) Bedrooms, all of which are designated for client use. All bedrooms are located on the second story and furnished for double occupancy. All bedrooms were equipped and supplied with appropriate furniture, bedding and linens. There were no visible hazards or discrepancies observed.

BATHROOMS: There are six (6) bathrooms, two (2) on the ground floor and four (4) on the second floor. The bathrooms located on the ground floor include a half bath in the main hallway for client use and a full bath attached to the office designated for staff use. The bathrooms located on the second floor are all full bathrooms and three (3) are designated for client use. 1 upstairs bathroom is designated for staff use only. All bathrooms were supplied with appropriate soap and paper towels. Water temperatures were measured

in client bathrooms and measured within the required range of 105 degrees F to 120 degrees F at the time of the visit.

KITCHEN: Appliances and fixtures appeared clean and functional. The facility is utilizing an off-site kitchen for food preparation. LPA informed Program Director that a waiver is required in order to use an off-site Report Continued on LIC 809-C