Facility Evaluation Report

At 10:00AM Licensing Program Analyst (LPA), Antonia Alvizar-Ettima conducted an announced Pre-Licensing visit to the above facility and met with Administrator Victoria N. Barrera, Operations Director Joanne Olalia and Licensee Ann Seisa.

Fire Clearance was approved on 05/10/2024 for a maximum capacity of six (6) residents, of which six (6) non-Ambulatory and hospice waiver approved for six (6) residents. The purpose of today’s visit is to inspect the facility to ensure that the physical plant is in compliance with rules and regulations of California Code of Regulations, Title 22, Division 6, Chapter 8. The facility is a single-story building in a residential community. During today’s visit at 10:55AM LPA inspected the physical plant inside and outside and observed the following:

KITCHEN: The facility has a kitchen area that is equipped with a refrigerator, a sink, dishwasher, and microwave. LPA observed adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6) residents. All knives and sharps are observed to be locked in a cabinet in the hallway next to the kitchen and inaccessible to residents. Fire Extinguishers were dated 01/15/24.

LAUNDRY ROOM: The laundry room is located outside the home next to the Accessory Dwelling Unit (ADU) and kept locked. The washer/dryer appear to be in good condition. Laundry supplies are kept inaccessible when not in use.

BEDROOMS: There are six (6) bedrooms designated for residents. All resident bedrooms are furnished with beds, dressers and required bedding and linen. The bedrooms have sufficient closet space and have sufficient lighting. Auditory alarms were tested and observed to be operational.