Facility Evaluation Report

Licensing Program Analyst (LPA) Emily Peraldi arrived at the facility unannounced to conduct a required annual visit. At 12:34 p.m., the LPA met with staff and explained the reason for the visit. At 12:56 p.m., the Administrator, Delia Cafuir arrived at the facility. The facility is vendored by Tri-Counties Regional Center as a level 4i home.

RECORD REVIEW: Between 12:56 p.m. and 1:56 p.m., the LPA conducted a file review for all four (4) clients and for five (5) staff and observed the following: Staff have current first aid and training completed. Client records were reviewed for, but not limited to current Individual Program Plan (IPP), medical records, P & I funds, admissions agreement, and consent forms. All records were in order. The last earthquake drill took place on 07/20/2025. Administrator’s Certificate is valid until 12/08/2026. The LPA observed documentation of the Infection Control Plan and Emergency and Disaster Plan.

Starting at 1:57 p.m., the LPA conducted a review of medication and medication documentation with the Administrator for two (2) out of four (4) clients and observed that medications were properly documented and assisted as prescribed.

Starting at 2:10 p.m., the LPA, along with the Administrator, toured the physical plant areas inside and outside to ensure there are no health and safety hazards. The facility is a single-story residence that consists of four (4) bedrooms, three (3) for client use and one (1) for staff use and two (2) bathrooms.