Facility Evaluation Report

At 10:00 a.m. Licensing Program Analysts (LPA) Esther Cortez arrived at the facility unannounced to conduct a required annual visit. When the LPA arrived, there were one (1) staff and no clients present. The LPA was greeted by staff Mary Jane Tagumasi and informed them of the reason for the visit. Designee Administrator Charles Carino arrived shortly thereafter. Clients arrived at approximately around 2:20 p.m.

The LPA and Designee conducted a tour of the physical plant to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was noted: Facility is a single-story residence that consists of three (3) resident bedrooms, one (1) office room and two (2) bathrooms. The home is vendored by Tri-Counties Regional Center as a level 4-I home. The LPA observed a fire extinguishers at the facility, which was fully charged and last serviced 10/16/2025. All smoke alarms and carbon monoxide detectors were tested. LPA observed all required postings in the hallway of the home.

Kitchen: During the facility tour the kitchen appeared clean and the appliances and fixtures functional. Sharp objects are stored in a in a locked drawer. Food is prepared based on a menu. Snacks and beverages are always available for the clients

Bedrooms: The LPA observed all client bedrooms properly furnished with at least one chair, nightstand and sufficient lighting for each client. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets.

Bathrooms: The LPA observed all restrooms to be clean, and properly supplied. Residents have sufficient supplies for personal hygiene. Water temperature in one of the restrooms was measured at 120.0 degrees Fahrenheit. Report will continue on LIC809-C.