Facility Evaluation Report

Licensing Program Analyst (LPA) Emily Peraldi arrived at the facility unannounced to conduct a required annual visit. At 9:30 a.m., the LPA met with one of the Administrators Joemar Ong and explained the reason for the visit. The facility is vendored by Tri-Counties Regional Center as a level 4I home.

RECORD REVIEW: Between 9:40 a.m. and 10:48 a.m., the LPA conducted a file review for all four (4) clients and four (4) staff and observed the following: Staff have current first aid and training completed. Client records were reviewed for, but not limited to current Individual Programming Plan (IPP), medical records, P & I funds, admissions agreement, and consent forms. All files were in order. The last fire drill took place on 03/15/2025.

Starting 10:17 a.m., the LPA conducted a review of medication and medication documentation with the Administrator for two (2) clients and observed that medications were properly documented and assisted as prescribed.

Starting at 10:49 a.m., the LPA, along with the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards. Facility is a double-story residence that consists of two (2) resident bedrooms, and one (1) bathroom on the first floor. The second floor is for staff and inaccessible to residents in care.

KITCHEN: The LPA observed the kitchen and dining area. Kitchen appliances are in operable condition. The facility has a sufficient supply of perishable and non-perishable food. At 10:40 a.m., hot water temperature measured at 107.4-degree Fahrenheit. Knives are stored in a locked box. Continued on LIC 809-C.