Facility Evaluation Report

On 05/22/2023 Licensing Program Analyst (LPA) David España conducted an announced visit to the facility for purpose of a pre-licensing evaluation. LPA was greeted at the front entrance by Administrator Dr. Sharouz Ghodsian and was granted access in the facility.

Dr. Sharouz Ghodsian submitted an application to Community Care Licensing Division (CCLD), for initial license for a Social Rehabilitation Facility to serve adults age range 18 through 59.

The requested capacity is for 6 clients of which are ambulatory clients. The facility is a 3-bedroom, 3 bathrooms, 1 story house. LPA España conducted a review of the Physical Plant, Bedrooms, Bathrooms, Supplies, Food Service, Medications, Records, Administration, Activities, Pre-Licensing Checklist and Component III Orientation.

MEDICATIONS: There is a locked centralized storage area for client medications.

PHYSICAL PLANT: Facility is clean, sanitary, and in good repair. Protective devices are in place to include nonslip material on rugs. Indoor and outdoor passageways, stairways, inclines, ramps, open porches, and other areas of potential hazard are free of obstructions. There is no pools and bodies of water that need fencing of at least five (5) feet high with self-closing, self-latching gates, or locked covers that can support the weight of an adult.

There is no locked storage area for firearms, poisons, and dangerous weapons. There is no separate locked storage area for ammunition. All window screens are clean and in good repair. Facility temperature is between 68 degrees and 85 degrees. Fireplaces and open-faced heaters are inaccessible to clients. Stairways, inclines, ramps, open porches, and areas of potential hazard are well-lit and equipped with sturdy hand railings. Fire Alarms and Smoke alarms operate properly. Carbon monoxide detectors operate properly.