Facility Evaluation Report

On 10/10/2024 at approximately 9:45am, Licensing Program Analyst (LPA) Perchui Milena Khurshudyan conducted a subsequent Pre-Licensing Inspection and met with the Staff/Caregiver Rosemarie Santos. LPA explained the reason for the visit. Facility Administrator Christine Cheng arrived shortly after.

This is a Change of Ownership Application from facility #197605213 to # 197610503 to operate an Adult Residential Facility Level 2. An Application to operate an Adult Residential Facility (ARF) was received on 09/25/2023 by Community Care Licensing (CCL). A fire clearance was approved on February 9th, 2024 for six (6) ambulatory clients, for a total capacity of six.

Purpose of today’s visit is to inspect the facility to ensure that the facility is in compliance with the rules and regulations of California Code of Regulations, Title 22, Division 6. Facility is a single story home. Today's site visit consisted of LPA touring the physical plant at 10:30am inside and outside and observed the following:

KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, microwave oven, gas stove and sink. The Facility has two (2) other frizer/refrigerators located in the patio and garage. There is an adequate supply of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6). An emergency supply of water was also observed in the kitchen and patio areas. Sharps, knives and kitchen chemicals were observed locked in a kitchen drawer.

BEDROOMS: There are five (5) bedrooms of which four (4) bedrooms are designated for clients' use, and one (1) is for staff. Bedroom #1 is currently occupied by two (2) clients, bedrooms #2, #3, #4 are private. All four (4) clients' rooms were furnished with beds, night stand, chairs, dresser, bedding and linen. All bedrooms have sufficient lighting and closet space. LPA toured and observed bedrooms to be clean and appropriately furnished. There are sufficient supplies of linen and towels in the linen cabinet.