Facility Evaluation Report

Licensing Program Analyst (LPA) Brian Balisi conducted an unannounced required annual visit

to the above facility. LPA met with administrator Daniela Mosquera and explained the reason for the visit. There were no clients present during the visit.

LPA conducted a tour of the physical plant areas inside and outside to ensure there are no health and safety hazards. This home is vendor by Tri-Counties Regional Center. The smoke detectors and carbon monoxide detectors were tested and functioned properly during the visit. The fire extinguishers were observed fully charged and last serviced on June 05, 2024. Fire alarm devices were last inspected of August of 2024.

There are six client bedrooms; four rooms on the permanent side and two rooms on the crisis side. All rooms were observed to be clean, appropriately furnished and had sufficient lighting during the time of the visit.

There are three (3) bathrooms at the home. Two on the permanent side and one on the crisis side. The bathrooms were clean and had non-skid mats. Hot water temperature was tested between 105 - 120 degrees Fahrenheit.

The kitchen appliances appeared clean and operational at the time of the visit. . Knives were observed stored in a locked safe on the counter. Cleaning supplies are stored in a locked cabinet in the hall near the entry.

The medications are centrally stored in a locked cabinet in a small office near the entryway. There is a computer located in the office for clients' use. PPE, residents personal snacks and other facility supplies were observed stored inaccessible in cabinets to the right of the entrance. A sufficient supply of emergency water was observed properly stored in entry way closet.