Facility Evaluation Report

On 11/05/2024, Licensing Program Analyst (LPA) M. Medina arrived unannounced to conduct a Pre-Licensing inspection. LPA introduced self, stated the purpose of the visit, and was granted entry to the facility. LPA met with Administrator Dio V Telmo and Socorro Ann Telmo.

The facility is being licensed as a change of ownership. The facility is a 5 bedroom, 2 1/2 bathroom home. Fire clearance has been approved for six (6) non-Ambulatory. There are currently 6 residents in placement.

LPA conducted a tour of the facility and observed the following. Facility appeared clean and at a comfortable temperature. Common areas were furnished with adequate lighting. Resident bedrooms were toured and observed to have the required furnishings. Bathrooms toured and observed to be operational. Hot water measured at 112.9 degrees F. Kitchen toured and observed to be safe for food preparation. LPA observed an adequate food supply.

First-Aid kit observed and contained all required items. Smoke detector and carbon monoxide detector observed to be operational during today's inspection. A fire extinguisher was observed to be last serviced on 04/01/2024.

Exterior tour conducted. All exits were open and free from obstructions. LPA observed the facility yard to be sufficient in size and appropriately equipped for outdoor use. There is seating and shade umbrella for resident seating. Pool is surrounded by a perimeter fence which was observed to be locked, secured, and inaccessible to residents.

I have found that the applicant has met all pre-licensing requirements. LPA will submit documentation to CAB in Sacramento for final review prior to license being issued. Exit interview conducted. A copy of this report will provided via email to Administrator, Dio V Telmo.