Facility Evaluation Report

On 04/12/2024 at 10:05 am, Licensing Program Analysts (LPAs) Raymond Comer and Micheal Cava announced purpose of visit for conducting a Pre-Licensing evaluation of the Facility. LPAs met with Administrator/Licensee Farhad Rahmati. An application to operate an Adult Residential Facility (ARF) Level II, was received by Community Care Licensing (CCL) on 10/03/2023. A fire clearance was approved on 03/04/2024, for two (2) ambulatory residents and two (2) non-ambulatory residents for a total capacity of four (4).

A tour of the physical plant was initiated at approximately 10:15 a.m. and the following was observed: A single story facility with an attached garage.

KITCHEN area is clean and clear of clutter. LPAs observed a refrigerator, microwave, stove/oven, dishwasher and sink to be operational. Plates, cups, utensils, A supply of perishable, and nonperishable food will be available upon facility's receipt of first resident. Knives/Sharps will be kept in observed in a locked kitchen drawer. Cleaning supplies and chemicals are\will be kept in a locked cabinet area in the garage and inaccessible to residents.

BEDROOMS: Facility has four (4) total bedrooms. Bedroom #1 is a shared resident room with its own Bathroom. Bedroom #2 and Bedroom#3 are private rooms for residents. Bedroom#4 is a space for Staff. All residents bedrooms observed with required beds, night stands, chairs, dressers, linens and appropriate lighting.

BATHROOMS: Facility has two (2) total bathrooms. Proper fixtures are working properly; grab bars and anti-slip matting observed. Paper towels, hand soap, toilet paper, and toiletries are observed. Hot water delivered to bathrooms measured a temperature between 108 degrees F. Within the required range.