Facility Evaluation Report

Licensing Program Analyst (LPA) Emily Peraldi arrived at the facility unannounced to conduct a required annual visit. At 12:30 p.m., the LPA met with staff and explained the reason for the visit. At 12:45 p.m., Administrator, Emilia Villanueva arrived at the facility. The facility is vendored by Tri-Counties Regional Center as a level 4G home.

RECORD REVIEW: Between 12:46 p.m. and 2:09 p.m., the LPA conducted a file review for all four (4) 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 Program Plan (IPP), medical records, P & I funds, admissions agreement, and consent forms. All records were in order. The last drill took place on 05/27/2025. The LPA observed documentation for the Infection Control Plan and Emergency and Disaster Plan. The Administrator certificate is valid until 02/13/2026.

Starting at 2:10 p.m., the LPA conducted a review of medication and medication documentation with the Administrator for two (2) out of four (4) clients and observed that medications were properly documented and assisted as prescribed.

Starting at 2:24 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. The facility is a single-story residence that consists of three (3) client bedrooms, one (1) office, and two (2) bathrooms.