Facility Evaluation Report

Licensing Program Analyst (LPA) Emily Peraldi arrived at the facility unannounced to conduct a required annual visit. At 9:00 a.m., the LPA met with staff and explained the reason for the visit. At 9:15 a.m., Administrator Charles Carino arrived at the facility. The facility is vendored by Tri-Counties Regional Center as a level 3 home.

RECORD REVIEW: Between 9:15 a.m. and 11:10 a.m., the LPA conducted a file review for all four (4) clients and staff regularly scheduled 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. Earthquake drill was conducted on 11/03/2025. Administrator’s Certificate is valid until 12/03/2025.

Starting 11:13 a.m., the LPA conducted a review of medication and medication documentation with staff for two (2) out of four (4) clients and observed that medications were properly documented and assisted as prescribed.

Starting at 11:30 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.

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 11:31 a.m., hot water temperature measured at 106.3-degree Fahrenheit. Knives are stored in a locked kitchen drawer. Medications and first aid are located inside a locked kitchen cabinet. Continued on LIC 809-C.