Facility Evaluation Report

Licensing Program Analyst (LPA) Emily Peraldi arrived at the facility unannounced for a required annual inspection today. At 10:00 a.m., the LPA met with staff and explained the reason for the visit. At 10:14 a.m., the Administrator Lailani Macasias arrived at the facility. There are three (3) consumers and two (2) staff in program today. The program currently operates from 8:30 a.m. to 3:00 p.m. Monday through Friday.

Record Review: Between 10:15 a.m. and 11:10 a.m., the LPA conducted a file review for four (4) consumers and for two (2) staff and observed the following: Staff have current first aid and training completed. Consumer records were reviewed for but not limited to current Individual Program Plan (IPP), medical assessments, admissions agreement, and consent forms. All records were in order. The last fire drill took place on 08/06/2025. The LPA observed documentation of the Infection Control Plan and Emergency and Disaster Plan. The Administrator certificate is valid until 03/12/2027.

Starting at 11:11 a.m., the LPA, along with the Administrator toured the physical plant to ensure there are no health and safety hazards.

Common Activity Space: The facility location is located in a business area of the community and consists of one building with multiple entrances and exits. The facility consists of one (1) large activity area, two (2) staff/ office rooms, one (1) dedicated activity room, a quiet room, one (1) bathroom and a food service area. The LPA did not observe any obstructions or hazards. There are several fire extinguishers throughout the facility; they all were fully charged and were last serviced on 06/03/2025. Continued on LIC 809-C.