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 10:18 a.m., Administrator Charles Carino arrived at the facility. The facility is vendored by Tri-Counties Regional Center as a level 4-I home.

RECORD REVIEW: Between 10:24 a.m. and 11:55 a.m., the LPA conducted a file review for all five (5) 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. Fire drill was conducted on 09/24/2025. Administrator’s Certificate is valid until 12/03/2025. The LPA observed documentation of the Infection Control Plan and Emergency and Disaster Plan.

Starting 11:57 a.m., the LPA conducted a review of medication and medication documentation with staff for three (3) clients and observed that medications were properly documented and assisted as prescribed.

Starting at 12:11 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 12:12 p.m., hot water temperature measured at 112.3-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.