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 staff and explained the reason for the visit. At 9:51 a.m., Administrator Erik Miranda arrived at the facility. The facility is vendored by Tri-Counties Regional Center as a level 4I home.

RECORD REVIEW: Between 09:54 a.m. and 12:00 p.m., the LPA conducted a file review for all six (6) clients and eight (8) staff and observed the following: Staff have current first aid. 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 files were in order. The last emergency disaster drill took place on 02/14/2026. The LPA observed documentation of the Infection Control Plan and Emergency and Disaster Plan. Administrator’s Certificate is currently pending for renewal.

Starting 12:02 p.m., the LPA conducted a review of medication and medication documentation with the Administrator for three (3) clients and observed that medications were properly documented and assisted as prescribed.

Starting at 12:30 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. 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 12:32 p.m., hot water temperature measured at 111.0-degree Fahrenheit. Knives are stored in a locked kitchen drawer. Continued on LIC 809-C.