Facility Evaluation Report

Licensing Program Analysts Kerry Hiratsuka and Jaynae Boyles, conducted this announced prelicensing visit.

This facility has a fire clearance for three ambulatory only residents. This facility has three private resident rooms and one office. The office and hallway to the resident rooms, and one full common bathroom are to the right of the main entrance. The largest of the resident rooms has a full private bathroom and an exit to the outside. The common areas, door leading to the garage, and kitchen are to the left of the main entrance. The garage has the clothes washer and dryer. The backyard is split into two areas: one that is going to be a garden that has a locked shed and the area is locked and does not have a gate that leads to the front yard. The other part of the backyard has a gate leading to the front yard.

Component III orientation was waived due to this being a change of location.

This facility meets regulations. LPA is going to submit this report to the application specialist.