Facility Evaluation Report

At 1:40 p.m. on this day, June 28, 2024, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual inspection. The facility appeared vacant. LPA called and spoke over the phone with Regional Director (RD) Lorenzo Pennix, and informed the reason for visit. RD and Ebony Omelagah, licensee, arrived at 2:30 p.m.

The facility underwent major repair as the result of fire back in 11/2022.

LPA toured the facility inside out with the RD and licensee. Repair appeared completed.

LPA verified, and licensee stated there's no major change in the physical plant lay out except the office is bigger than it was before and the closet of one of the bedrooms was changed to the opposite side of the bedroom.

Licensee to submit an updated sketch to LPA by July 12, 2024. In addition, licensee to check with the fire department if inspection is needed and inform LPA, so LPA can proceed to the next step if fire inspection is needed.

Licensee and RD stated that assessment of prospective resident has started.

Licensee and/or RD to submit the following documents before admission of first resident, and to notify LPA when first resident is admitted:

1. LIC308 Designation of Facility Responsibility

3. LIC610D Emergency Disaster Plan (9 pages)

No deficiency cited. Exit interview conducted and copy of this report provided.