Facility Evaluation Report

Licensing Program Analyst (LPA) Jose Villalobos conducted an announced visit with applicant Jennifer Zhang. The purpose of the visit was to conduct the subsequent Pre-Licensing visit to observe corrections.

An application was submitted to CCLD on 11/3/2023, for a Change of Ownership of a Residential Care Facility for the Elderly. The requested capacity of 99 residents, (0) ambulatory, (99) non-ambulatory and (0) may be bedridden. Hospice Waiver request was submitted for up to Fifteen (15) residents.

The facility is currently operating under Facility # 198603374

- Repairs to Room #301 have been finished and obstructions in the hallways observed.

- Room #301 has been furnished with required bed, bedding supplies, chair, and night stand with lamp

An exit interview was conducted and a copy of this report has been furnished to the applicant . Accordingly, LPA will submit a copy of this facility evaluation report to the Central Applications Bureau (CAB) for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with the CAB Analyst assigned to their application