Facility Evaluation Report

Licensing Program Analyst (LPA) Emily Peraldi arrived at the facility unannounced to conduct a required annual visit. At 10:30 a.m., the LPA arrived at the facility and spoke with the Administrator, Melanie Marin and explained the reason for the visit. At 10:46 a.m., the Administrator arrived at the facility. The facility is vendored by Tri-Counties Regional Center as a level 3 home.

RECORD REVIEW: Between 10:52 a.m. and 12:11 p.m., the LPA conducted a file review for all five (5) clients and for six (6) 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 records were in order. The last earthquake drill took place on 04/17/2025 and fire drill on 03/15/2025. Administrator’s Certificate is valid until 02/09/2026. The LPA observed documentation of the Infection Control Plan and Emergency and Disaster Plan.

Starting at 12:16 p.m., the LPA conducted a review of medication and medication documentation with the Administrator for three (3) out of five (5) clients and observed that medications were properly documented and assisted as prescribed.

Starting at 12:33 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. 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.