Facility Evaluation Report

Licensing Program Analyst (LPA) Shawna Doucette arrived to the facility announced to conduct the Pre licensing visit. LPA Shawna Doucette met with Administrator Furaija Libao who granted LPA entry into the facility.

LPA toured facility. Common rooms have adequate furnishings and lighting. All of the resident bedrooms have all the required furnishings and adequate lighting. Hot water temperature in bathrooms measured at 119.4 degrees F. LPA observed a supply of extra bed linens and personal hygiene and grooming products. Kitchen observed to have dishes, plates, utensils. Cleaning supplies are stored in a locked under sink cabinet. Medications are locked in a medication cabinet. First aid kit contains all the required items. A fire extinguisher is present and has a service date of 10/126/2021. Fire alarm and carbon monoxide were tested and working.

Outside of the facility toured. Exits open free of obstruction, perimeter gate around facility is in place. No outside hazards were observed.

All required postings are posted. Facility phone number will be (661) 364-8589 .

Component III was conducted during pre-licensing visit with Applicants.

I have found that applicant has met all pre licensing requirements. LPA will submit documentation to CAB in Sacramento for final review prior to license being issued.