Facility Evaluation Report

On 8/15/2024 Licensing Program Analyst (LPA) Melissa Spaeth conducted an announced pre-Licensing visit to this facility and met with the Licensee. This is a new application and a fire clearance dated 5/21/2024 was received for four (4) ambulatory residents.

The purpose of today’s visit is to inspect the facility to ensure that it maintains compliance under California Code of Regulations, Title 22, Division 6. Component III was conducted with the applicant from 10:44 until 11:30 am.

Today’s site visit consisted of LPA touring the physical plant inside and outside from 11:45 am until 12:40 pm LPA Spaeth observed the following:

Living Room – the living room is spacious and furnished with comfortable seating.

Kitchen/Dining Room - The facility contained a seven day supply of non-perishable food and a two day supply of perishable foods. A fire extinguisher is also located in the kitchen. Appliances in the kitchen appeared to be functional. The dining room contained a table and chairs. The knives were locked in a kitchen cabinet. The resident files, staff files, and the client medications are locked in a kitchen cabinet.

The cleaning solutions were safely locked underneath the kitchen sink. The first aid kit is located in a dining room drawer.

Bathrooms - There are two bathrooms which contained hand soap, paper towels, and a trash can. The water temperature was tested at 11:15 am and was 116.0 degrees F.